title: Association of Pulmonary Tuberculosis and Diabetes in Mexico: Analysis of the National Tuberculosis Registry 2000-2012.
abstract: BACKGROUND
  Tuberculosis (TB) remains a public health problem in Mexico while the incidence of diabetes mellitus type 2 (DM) has increased rapidly in recent years.
  
  
  OBJECTIVE
  To describe the trends of incidence rates of pulmonary TB associated with DM and not associated with DM and to compare the results of treatment outcomes in patients with and without DM.
  
  
  METHODS
  We analysed the National Tuberculosis Registry from 2000 to 2012 including patients with pulmonary TB among individuals older than 20 years of age. The association between DM and treatment failure was analysed using logistic regression, accounting for clustering due to regional distribution.
  
  
  RESULTS
  In Mexico from 2000 to 2012, the incidence rates of pulmonary TB associated to DM increased by 82.64%, (p<0.001) in contrast to rates of pulmonary TB rate without DM, which decreased by 26.77%, (p<0.001). Patients with a prior diagnosis of DM had a greater likelihood of failing treatment (adjusted odds ratio, 1.34 (1.11-1.61) p<0.002) compared with patients who did not have DM. There was statistical evidence of interaction between DM and sex. The odds of treatment failure were increased in both sexes.
  
  
  CONCLUSIONS
  Our data suggest that the growing DM epidemic has an impact on the rates of pulmonary TB. In addition, patients who suffer from both diseases have a greater probability of treatment failure.
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Delgado-Sánchez
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Lourdes
authors.initials: L
authors.lastname: García-García
authors.affiliation: Dirección de Micobacteriosis, Centro Nacional de Programas Preventivos y Control de Enfermedades, México, Distrito Federal, México.
authors.forename: Martín
authors.initials: M
authors.lastname: Castellanos-Joya
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Pablo
authors.initials: P
authors.lastname: Cruz-Hervert
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Leticia
authors.initials: L
authors.lastname: Ferreyra-Reyes
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ferreira-Guerrero
authors.affiliation: Departamento de Epidemiología, Instituto Nacional de Enfermedades Respiratorias, México, Distrito Federal, México.
authors.forename: Andrés
authors.initials: A
authors.lastname: Hernández
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Victor Manuel
authors.initials: VM
authors.lastname: Ortega-Baeza
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Rogelio
authors.initials: R
authors.lastname: Montero-Campos
authors.affiliation: Dirección de Micobacteriosis, Centro Nacional de Programas Preventivos y Control de Enfermedades, México, Distrito Federal, México.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Sulca
authors.affiliation: Dirección de Micobacteriosis, Centro Nacional de Programas Preventivos y Control de Enfermedades, México, Distrito Federal, México.
authors.forename: Ma de Lourdes
authors.initials: Mde L
authors.lastname: Martínez-Olivares
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Norma
authors.initials: N
authors.lastname: Mongua-Rodríguez
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Renata
authors.initials: R
authors.lastname: Baez-Saldaña
authors.affiliation: Dirección General, Centro Nacional de Programas Preventivos y Control de Enfermedades, México, Distrito Federal, México.
authors.forename: Jesús Felipe
authors.initials: JF
authors.lastname: González-Roldán
authors.affiliation: Centro de Investigación sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Hugo
authors.initials: H
authors.lastname: López-Gatell
authors.affiliation: Laboratorio de Microbiología, Instituto Nacional de Ciencias Médicas y de Nutrición "Salvador Zubirán", México, Distrito Federal, México.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Ponce-de-León
authors.affiliation: Dirección Médica, Instituto Nacional de Ciencias Médicas y de Nutrición "Salvador Zubirán", México, Distrito Federal, México.
authors.forename: José
authors.initials: J
authors.lastname: Sifuentes-Osornio
authors.affiliation: Dirección General Adjunta de Epidemiología, Dirección General de Epidemiología, México, Distrito Federal, México.
authors.forename: María Eugenia
authors.initials: ME
authors.lastname: Jiménez-Corona
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology* / Q000266:history; D005260:Female; D049674:History, 21st Century; D006801:Humans; D015994:Incidence; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D016017:Odds Ratio; D062486:Public Health Surveillance; D012042:Registries; D017211:Treatment Failure; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000453:epidemiology* / Q000266:history