title: Effect of Diabetes Mellitus on Tuberculosis Treatment Outcome and Adverse Reactions in Patients Receiving Directly Observed Treatment Strategy in India: A Prospective Study.
abstract: Despite successful implementation of directly observed treatment, short course (DOTS) in India, the growing number of diabetes mellitus (DM) patients appears to be a cause in the increasing tuberculosis (TB) incidence, affecting their management. In this regard, a prospective study was conducted on DOTS patients in three primary health care centers in urban slum region of South Delhi, India, to evaluate the effect of DM on sputum conversion, treatment outcome, and adverse drug reactions (ADR) due to anti-TB treatment. Eligible TB patients underwent blood glucose screening at treatment initiation. Disease presentation, clinical outcome, and ADRs were compared between patients of TB with and without DM. Out of 316 patients, the prevalence of DM was found to be 15.8%, in which 19.4% and 9.6% were PTB and EPTB patients, respectively. DM patients have observed higher sputum positivity (OR 1.247 95% CI; 0.539-2.886) at the end of 2-month treatment and poor outcome (OR 1.176 95% CI; 0.310-4.457) at the completion of treatment compared with non DM patients. Presence of DM was significantly associated (OR 3.578 95% CI; 1.114-11.494, p = 0.032) with the development of ADRs. DM influences the treatment outcome of PTB patients in our setting and also on the ADR incidence.
authors.affiliation: Department of Pharmaceutical Medicine, Faculty of Pharmacy, Jamia Hamdard, New Delhi 110062, India.
authors.forename: Ali Nasir
authors.initials: AN
authors.lastname: Siddiqui
authors.affiliation: Department of Epidemiology & Public Health, National Institute of TB and Respiratory Diseases, New Delhi 110030, India.
authors.forename: Khalid Umer
authors.initials: KU
authors.lastname: Khayyam
authors.affiliation: Department of Pharmacology, Faculty of Pharmacy, Jamia Hamdard, New Delhi 110062, India.
authors.forename: Manju
authors.identifier: 0000-0003-4013-6626
authors.initials: M
authors.lastname: Sharma
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D001786:Blood Glucose / Q000187:drug effects; D003920:Diabetes Mellitus / Q000453:epidemiology* / Q000209:etiology; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D011320:Primary Health Care; D011446:Prospective Studies; D013183:Sputum / Q000737:chemistry; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents; D001786:Blood Glucose