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Unfavourable treatment outcomes in tuberculosis patients with different vitamin D status and blood glucose levels in a programme setting in China
Author(s) -
Lin Yan,
Bai Yunlong,
Zhang Tiejuan,
Kang Wanli,
Kang Demei,
Miao Qiang,
Wang Yunlong,
Shao Hongshan,
Li Xiangwen,
Brigden Grania,
Dlodlo Riitta A.,
Harries Anthony D.
Publication year - 2020
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.13355
Subject(s) - medicine , tuberculosis , logistic regression , prospective cohort study , diabetes mellitus , cohort , pulmonary tuberculosis , pathology , endocrinology
Objective Tuberculosis (TB) treatment success rates are high in China, but there are still a considerable number of cases who have unfavourable treatment outcomes (UTO). We aimed to determine the proportion of TB patients with UTO and to assess whether baseline characteristics that included glycaemic status [normal fasting blood glucose (FBG), transient hyperglycaemia and diabetes mellitus (DM)] and vitamin D status were associated with UTO. Method Prospective cohort study conducted between November 2015 and July 2016 at six clinics within routine TB services in Jilin province, where persons with TB were consecutively recruited. Data analysis was performed using the chi‐squared test and multivariate logistic regression. Results Of the 306 recruited TB patients, 96 (31.4%) had smear‐positive pulmonary TB, 187 (61.1%) had smear‐negative pulmonary TB and 23 (7.5%) had extrapulmonary TB (EPTB). Of these, 95 (31.1%) had normal blood glucose, 83 (27.1%) had transient hyperglycaemia and 128 (41.8%) had DM. 227 (74.2%) patients had vitamin D deficiency/severe deficiency. There were 125 (40.8%) patients with UTO of whom the majority were lost to follow‐up (57.6%) or not evaluated (28.8%). UTO was significantly associated with smear‐negative pulmonary TB ( P = 0.009), EPTB ( P < 0.001) and DM ( P = 0.007). Conclusion The proportion of TB patients with UTO increased with smear‐negative pulmonary TB, EPTB and DM. TB programmes need to pay more attention to these issues and ensure intensive patient support to those at risk and early detection of DM.