title: Effect of diabetes on tuberculosis presentation and outcomes in Kiribati.
abstract: OBJECTIVE
  To determine the association between diabetes and the clinical features and treatment outcomes of TB in Kiribati.
  
  
  METHODS
  We enrolled consecutive patients with TB who presented from August 2010 to February 2012 and compared clinical features and TB treatment outcomes for patients with and without diabetes, as measured by haemoglobin A1c assay. Poor outcome was defined as death, default or treatment failure, and good outcome as treatment success or cure.
  
  
  RESULTS
  Two hundred and seventy-five eligible persons with TB disease were enrolled; 101 (37%) had diabetes. TB patients with diabetes were more likely to have acid-fast bacilli (AFB) seen on sputum smear microscopy (RR: 1.3; 95% CI: 1.03-1.62). The risk of poor outcome did not differ between patients with or without diabetes (RR: 1.1; 95% CI: 0.5-2.7).
  
  
  CONCLUSIONS
  TB patients with diabetes are more likely than those without to have sputum with AFB on microscopy. This could increase transmission in the community. Early detection of TB by screening patients with diabetes, and the converse, could be important public health interventions where diabetes and TB are prevalent.
authors: Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors: J
authors: J
authors: Cavanaugh
authors: Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia.|National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
authors: K
authors: K
authors: Viney
authors: National TB Program, Ministry of Health and Medical Services, Tarawa, Kiribati.
authors: T
authors: T
authors: Kienene
authors: National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
authors: D
authors: D
authors: Harley
authors: Population Health Division, ACT Government Health Directorate, Canberra, ACT, Australia.|Australian National University Medical School, Canberra, ACT, Australia.
authors: P M
authors: PM
authors: Kelly
authors: National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
authors: A
authors: A
authors: Sleigh
authors: Public Health Consultant, Auckland, New Zealand.
authors: J
authors: J
authors: O'Connor
authors: Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors: S
authors: S
authors: Mase
keywords: Pacific; Pacifique; Pacífico; Tuberculosis; case-control study; diabetes mellitus; diabète sucré; estudio caso-control; resultados de tratamiento; résultats du traitement; treatment outcomes; tuberculose; étude cas-témoins
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