Effect of Diabetes Mellitus on Tuberculosis Treatment Outcomes among Tuberculosis Patients in Kelantan, Malaysia
-
Siti Rohana AHMAD
,
Nor Azwany YAACOB
,
Mat Zuki JAEB
,
Zalmizy HUSSIN
,
Wan Mohd Zahiruddin WAN MOHAMMAD
Abstract
Background: There is growing evidence that DM may play an important role in the occurrence of unsuccessful TB treatment outcomes. This study was undertaken to examine the prevalence of DM among TB population, compare the profile of TB patients with and without DM and determine the effect of DM on unsuccessful treatment outcomes among TB patients in Kelantan state, Malaysia from 2012 to 2016.
Methods: A cross sectional study was conducted in Sep 2017 using data from registered TB cases in Kelantan state, Malaysia from 2012 to 2016. The profile of TB patients with and without DM were compared in univariable analysis. Multiple logistic regression was used to determine association between DM and unsuccessful treatment outcomes.
Results: A total of 1854 TB patients were diagnosed with DM. The annual proportion was ranging from 26 to 29%. TB patients with DM had an older age, live single, low educational status, poor chest x ray finding and diagnosed with smear positive sputum compared to TB patients without DM. TB patients with DM had three times higher risk to develop unsuccessful TB treatment outcomes compared to TB patients without DM (95% CI 2.47-3.58; P = 0.012) in multivariable analysis.
Conclusion: Those with DM had the worst prognosis of TB outcomes among the significant risk factors. TB control program in Malaysia will need to expand efforts to focus on treatment of TB-DM patients to improve their cure rates in order to achieve the goals of tuberculosis elimination.
References
Golden MP, Vikram HR. Extrapulmonary tuberculosis: an overview. American family physician. 2005;72(9).
World Health Organization. Global Tuberculosis Report. Geneva, Switzerland: World Health Organization; 2016.
Liew SM, Khoo EM, Ho BK, Lee YK, Mimi O, Fazlina MY, et al. Tuberculosis in Malaysia: predictors of treatment outcomes in a national registry. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 2015;19(7):764-71.
World Health Organization. Global Tuberculosis Report. Geneva, Switzerland: World Health Organization; 2013.
Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. The Lancet Infectious diseases. 2009;9(12):737-46.
NHMS. National Health Morbidity Survey 2011, Ministry Of Health, Malaysia. 2011.
Baker MA, Harries AD, Jeon CY, Hart JE, Kapur A, Lönnroth K, et al. The impact of diabetes on tuberculosis treatment outcomes: a systematic review. BMC medicine. 2011;9(1):81.
Baker MA, Harries AD, Jeon CY, Hart JE, Kapur A, Lonnroth K, et al. The impact of diabetes on tuberculosis treatment outcomes: a systematic review. BMC medicine. 2011;9:81.
Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS medicine. 2008;5(7):e152.
Stevenson CR, Forouhi NG, Roglic G, Williams BG, Lauer JA, Dye C, et al. Diabetes and tuberculosis: the impact of the diabetes epidemic on tuberculosis incidence. BMC public health. 2007;7:234.
Bailey SL, Grant P. 'The tubercular diabetic': the impact of diabetes mellitus on tuberculosis and its threat to global tuberculosis control. Clinical medicine. 2011;11(4):344-7.
Syed Sulaiman SA, Ishaq Aweis DM, Mohamed AJ, RazakMuttalif A, Moussa MA. Role of diabetes in the prognosis and therapeutic outcome of tuberculosis. International journal of endocrinology. 2012;2012.
MOH. Clinical Practice Guideline: Management of type 2 diabetes mellitus. Malaysia2015.
Alisjahbana B, Sahiratmadja E, Nelwan EJ, Purwa AM, Ahmad Y, Ottenhoff TH, et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clinical Infectious Diseases. 2007;45(4):428-35.
Jumaev G, Tillashaykhov M, Muazzamov B, Radjabov B, Gadoev J, Alikhanova N, et al. Original research PreVaLenCe, CharaCTerISTICS anD TreaTmenT ouTComeS of aLL PaTIenTS WITh neW TuBerCuLoSIS anD DIaBeTeS meLLITuS In 2011–2013, BuKhara, uZBeKISTan. Panorama. 2016.
Workneh MH, Bjune GA, Yimer SA. Diabetes mellitus is associated with increased mortality during tuberculosis treatment: a prospective cohort study among tuberculosis patients in South-Eastern Amahra Region, Ethiopia. Infectious diseases of poverty. 2016;5(1):22.
Atif M, Sulaiman SAS, Shafie AA, Ali I, Asif M, Babar Z-U-D. Treatment outcome of new smear positive pulmonary tuberculosis patients in Penang, Malaysia. BMC infectious diseases. 2014;14:399-.
Cavanaugh J, Viney K, Kienene T, Harley D, Kelly PM, Sleigh A, et al. Effect of diabetes on tuberculosis presentation and outcomes in Kiribati. Tropical medicine & international health : TM & IH. 2015;20(5):643-9.
Nissapatorn V, Kuppusamy I, Jamaiah I, Fong MY, Rohela M, Anuar AK. Tuberculosis in diabetic patients: a clinical perspective. The Southeast Asian journal of tropical medicine and public health. 2005;36 Suppl 4:213-20.
Sulaiman SA, Khan AH, Muttalif AR, Hassali MA, Ahmad N, Iqubal MS. Impact of diabetes mellitus on treatment outcomes of tuberculosis patients in tertiary care setup. The American journal of the medical sciences. 2013;345(4):321-5.
Kirkman MS, Briscoe VJ, Clark N, Florez H, Haas LB, Halter JB, et al. Diabetes in older adults. Diabetes care. 2012;35(12):2650-64.
Balakrishnan S, Vijayan S, Nair S, Subramoniapillai J, Mrithyunjayan S, Wilson N, et al. High diabetes prevalence among tuberculosis cases in Kerala, India. PloS one. 2012;7(10):e46502.
Chiang CY, Bai KJ, Lin HH, Chien ST, Lee JJ, Enarson DA, et al. The influence of diabetes, glycemic control, and diabetes-related comorbidities on pulmonary tuberculosis. PloS one. 2015;10(3):e0121698.
Delgado-Sanchez G, Garcia-Garcia L, Castellanos-Joya M, Cruz-Hervert P, Ferreyra-Reyes L, Ferreira-Guerrero E, et al. Association of Pulmonary Tuberculosis and Diabetes in Mexico: Analysis of the National Tuberculosis Registry 2000-2012. PloS one. 2015;10(6):e0129312.
Ruslami R, Aarnoutse RE, Alisjahbana B, van der Ven AJ, van Crevel R. Implications of the global increase of diabetes for tuberculosis control and patient care. Tropical medicine & international health : TM & IH. 2010;15(11):1289-99.
Lee PH, Fu H, Lai TC, Chiang CY, Chan CC, Lin HH. Glycemic Control and the Risk of Tuberculosis: A Cohort Study. PLoS medicine. 2016;13(8):e1002072.
Pereira SM, Araujo GS, Santos CA, Oliveira MG, Barreto ML. Association between diabetes and tuberculosis: case-control study. Revista de saude publica. 2016;50:82.
Viney K, Cavanaugh J, Kienene T, Harley D, Kelly PM, Sleigh A, et al. Tuberculosis and diabetes mellitus in the Republic of Kiribati: a case-control study. Tropical medicine & international health : TM & IH. 2015;20(5):650-7.
Ottmani SE, Murray MB, Jeon CY, Baker MA, Kapur A, Lonnroth K, et al. Consultation meeting on tuberculosis and diabetes mellitus: meeting summary and recommendations. The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease. 2010;14(12):1513-7.
| Files | ||
| Issue | Vol 49 No 8 (2020) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v49i8.3892 | |
| PMCID | PMC7554400 | |
| PMID | 33083325 | |
| Keywords | ||
| Tuberculosis Diabetes mellitus; Tuberculosis treatment outcomes | ||
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