Impact of diabetes on clinical presentation and treatment outcome of pulmonary tuberculosis in Beijing.
Diabetes mellitus (DM) is currently known to be one of the risk factors for pulmonary tuberculosis (PTB) and the proportion of DM in PTB is rising along with the increased prevalence of DM in countries with high PTB burden. This study was designed to explore the impact of DM on clinical presentation and treatment outcome of PTB in China. In an urban setting in Beijing, 1126 PTB patients, 30·6% with positive sputum smear, registered in two PTB dispensaries from January 2010 to December 2011 were screened for DM and were followed up prospectively during PTB treatment. DM was observed in 16·2% of patients with PTB. PTB with DM appeared to be associated with older age and a higher proportion of re-treatment. On presentation, DM was associated with more severe PTB signs with higher proportions of smear positivity [odds ratio (OR) 2·533, 95% confidence interval (CI) 1·779-3·606], cavity (OR 2·253, 95% CI 1·549-3·276) and more symptoms (OR 1·779, 95% CI 1·176-2·690). DM was also associated with non-TB deaths (OR 5·580, 95% CI 2·182-14·270, P < 0·001) and treatment failure (OR 6·696, 95% CI 2·019-22·200, P = 0·002). In Beijing, the findings of this study underlined the need to perform early bi-directional screening programmes and explore the underlying mechanism for different treatment outcomes for PTB with DM.
Department of Epidemiology and Biostatistics, School of Public Health,Peking University,Beijing,China.
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C
Hongguang
Department of Epidemiology and Biostatistics, School of Public Health,Peking University,Beijing,China.
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L
Min
National Center for Tuberculosis Control and Prevention,China CDC,Beijing,China.
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J
Shiwen
Department of Epidemiology and Biostatistics, School of Public Health,Peking University,Beijing,China.
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G
Fanghui
PTB Dispensary of Fangshan District,Beijing,China.
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H
Shaoping
PTB Dispensary of Changping District,Beijing,China.
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G
Tiejie
PTB Dispensary of Fangshan District,Beijing,China.
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L
Na
PTB Dispensary of Changping District,Beijing,China.
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Z
Zhiguo
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002681:China; D048909:Diabetes Complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D014505:Urban Population; D055815:Young Adult
D000995:Antitubercular Agents