title: Outcome of tuberculosis treatment in patients with diabetes mellitus treated in the revised national tuberculosis control programme in Malappuram District, Kerala, India.
abstract: METHODS
  Kerala State, India has reported the greatest dual burden of Tuberculosis (TB) and Diabetes Mellitus (DM). Malappuram district in Kerala has monitored and recorded DM status and its control from 2010 under Revised National Tuberculosis Control Program (RNTCP).
  
  
  OBJECTIVE
  To assess, under programme conditions, comprehensiveness of recording DM status among TB cases and the TB treatment outcomes among DM patients (disaggregated by glycemic control) and compare with-non DM patients.
  
  
  METHODS
  This retrospective record review included 3,116TB patients from April 2010 to September 2011.DM was defined as per international guidelines and TB treatment outcomes were categorized as favourable(cured and treatment completed) and unfavourable(death, default, failure and transfer out). Relative Risk (RR) and 95% confidence intervals(CI) were calculated to assess the risk of unfavourable outcomes.
  
  
  RESULTS
  DM status was recorded in 90% of TB cases and 667 (24%) had DM. 17% of DM patients and 23% of patients with unknown DM status had unfavourable outcomes but this difference was not statistically significant. Unadjusted RR for poor glycemic control or unknown control status for unfavourable outcome were (2.00; 95% CI 0.97-4.13) and (2.14; 95% CI 1.11-4.13).
  
  
  CONCLUSIONS
  This study could not confirm an adverse association between DM or its control during treatment and the course of response to TB treatment.DM screening in TB cases and recording of DM care needs to be improved to enable more conclusive evidence.
authors.affiliation: District Tuberculosis Centre, Manjeri, Malappuram District, Kerala, India.
authors.forename: Nandakumar
authors.initials: N
authors.lastname: K V
authors.forename: Karthickeyan
authors.initials: K
authors.lastname: Duraisamy
authors.forename: Shibu
authors.initials: S
authors.lastname: Balakrishnan
authors.forename: Sunilkumar
authors.initials: S
authors.lastname: M
authors.forename: Jaya Sankar
authors.initials: JS
authors.lastname: S
authors.forename: Karuna D
authors.initials: KD
authors.lastname: Sagili
authors.forename: Srinath
authors.initials: S
authors.lastname: Satyanarayana
authors.forename: Ajay Kumar
authors.initials: AK
authors.lastname: M V
authors.forename: Donald A
authors.initials: DA
authors.lastname: Enarson
mesh_terms: D000328:Adult; D003710:Demography; D048909:Diabetes Complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*