Effect of diabetes on treatment outcome of smear-positive pulmonary tuberculosis--a report from South India.
OBJECTIVE
To assess the effect of diabetes on tuberculosis (TB) treatment outcome and sputum conversion among new smear-positive (NSP) cases registered under Directly Observed Treatment Short Course in South India.


METHODS
Details on sputum conversion and TB treatment outcome were collected from case records of NSP cases (N = 332; M/F 247:85) registered at TB units of three districts in Tamil Nadu. Subjects were screened for diabetes and categorized as diabetic (TBDM) (n = 96; 73:23) and non-diabetic (TBnonDM) (n = 149; 109:40).


RESULTS
Among 245 selected TB patients, 93.5% were cured, 1.6% completed TB treatment, 2% had TB treatment failure (TF), and 0.4% had treatment default (TD), 0.4% with MDR-TB and 2% death rate. At the end of intensive phase of TB treatment, 14.7% remained sputum positive in the TBDM group, whereas it was 3.5% in the TBnonDM group. Mean duration (days) for sputum conversion was higher in the TBDM group (64.2 ± 10.5) compared to the TBnonDM group (61.5 ± 7.5) (p<0.001). TF rate was higher (4.2% vs 0.7%) and MDR-TB (1%) was also seen in the TBDM group. No death and TD were seen among DM whereas it was 3.4 and 0.7% in TBnonDM.


CONCLUSIONS
Delayed sputum conversion and high TB treatment failure rates were common in NSP cases with diabetes.
M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Education, Research and Training in Diabetes), Royapuram, Chennai, India. Electronic address: drvijay@mvdiabetes.com.
Vijay
V
Viswanathan
M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Education, Research and Training in Diabetes), Royapuram, Chennai, India.
A
A
Vigneswari
M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Education, Research and Training in Diabetes), Royapuram, Chennai, India.
K
K
Selvan
M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Education, Research and Training in Diabetes), Royapuram, Chennai, India.
K
K
Satyavani
M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Education, Research and Training in Diabetes), Royapuram, Chennai, India.
R
R
Rajeswari
M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Education, Research and Training in Diabetes), Royapuram, Chennai, India.
Anil
A
Kapur
D000328:Adult; D003581:Cytodiagnosis; D048909:Diabetes Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology / Q000628:therapy*; D055815:Young Adult
Diabetes; South India; Treatment outcome; Tuberculosis