title: Type 2 diabetes mellitus and its influence in the development of multidrug resistance tuberculosis in patients from southeastern Mexico.
abstract: OBJECTIVE
  To determine the factors associated with the presence of pulmonary tuberculosis in patients with type 2 diabetes mellitus and the effect in the development of drug and multi-drug resistance, in a population with tuberculosis from the southeast of Mexico.
  
  
  METHODS
  This is a case-control study including 409 individuals, 146 with the binomial tuberculosis-type 2 diabetes mellitus and 263 individuals with tuberculosis. Demographic, epidemiological and outcome variables were collected. Risks were calculated.
  
  
  RESULTS
  The factors associated with the presence of type 2 diabetes mellitus were age ≥35years, (OR=9.7; CI: 5.2-17.8), previous contact with a person infected with tuberculosis (OR=1.7; CI: 1.1-3.1). Body mass index ≥25 kg/m(2) (OR=2.2; CI: 1.1-4.3), and inherited family history of diabetes (OR=5.4; CI: 3.2-9.2). It was also found that patients with tuberculosis-type 2 diabetes mellitus presented a 4.7-fold (CI: 1.4-11.3) and 3.5-fold (CI: 1.1-11.1) higher risk of developing drug- and multidrug resistance tuberculosis, respectively. By last, individuals with tuberculosis-type 2 diabetes had a 2.3-fold (CI: 1.5-4.1) greater chance of persisting as tuberculosis-positive by the second month of treatment, delaying the resolution of the tuberculosis infection.
  
  
  CONCLUSIONS
  Type 2 diabetes exerts a strong influence on the presentation and evolution of tuberculosis within the analyzed population and displays remarkable particularities, necessitating the development of dedicated tuberculosis-diabetes surveillance systems that consider the particular epidemiological characteristics of the population affected.
authors.affiliation: Public Health Institute, University of Veracruz, Veracruz, Mexico; Doctoral program in Biomedical Sciences, Biomedical Research Center, University of Veracruz, Veracruz, México. Electronic address: lucymonsepn@yahoo.com.mx.
authors.forename: Lucia Monserrat
authors.initials: LM
authors.lastname: Pérez-Navarro
authors.affiliation: Micobacteriosis State Program, Veracruz Health Services, Mexico. Electronic address: javierfuentesd@gmail.com.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Fuentes-Domínguez
authors.affiliation: Public Health Institute, University of Veracruz, Veracruz, Mexico. Electronic address: robzencue@gmail.com.
authors.forename: Roberto
authors.initials: R
authors.lastname: Zenteno-Cuevas
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D015897:Comorbidity; D016001:Confidence Intervals; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents
keywords: Drug resistance; Multidrug resistance; Risk factors; TB-2DM comorbidity; Tuberculosis; Type 2 diabetes