Diabetes Mellitus and Tuberculosis Treatment Outcomes in Pune, India.
India
diabetes mellitus
mortality
tuberculosis
unfavorable treatment outcomes
Journal
Open forum infectious diseases
ISSN: 2328-8957
Titre abrégé: Open Forum Infect Dis
Pays: United States
ID NLM: 101637045
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
02
11
2020
accepted:
01
03
2021
entrez:
22
4
2021
pubmed:
23
4
2021
medline:
23
4
2021
Statut:
epublish
Résumé
Diabetes mellitus (DM) increases the risk of tuberculosis (TB) disease. Knowledge of the impact of DM on TB treatment outcomes is primarily based on retrospective studies. We conducted a prospective cohort study of new pulmonary TB patients with and without DM (TB-DM and TB only) in India. The association of DM with a composite unfavorable TB treatment outcome (failure, recurrence, mortality) over 18 months was determined, and the effect of DM on all-cause mortality and early mortality (death during TB treatment) was assessed. Of 799 participants, 574 (72%) had TB only and 225 (28%) had TB-DM. The proportion of patients with DM who experienced the composite outcome was 20%, as compared with 21% for TB-only participants (adjusted hazard ratio [aHR], 1.13; 95% CI, 0.75-1.70). Mortality was higher in participants with DM (10% vs 7%), and early mortality was substantially higher among patients with DM (aHR, 4.36; 95% CI, 1.62-11.76). DM was associated with early mortality in this prospective cohort study, but overall unfavorable outcomes were similar to participants without DM. Interventions to reduce mortality during TB treatment among people with TB-DM are needed.
Sections du résumé
BACKGROUND
BACKGROUND
Diabetes mellitus (DM) increases the risk of tuberculosis (TB) disease. Knowledge of the impact of DM on TB treatment outcomes is primarily based on retrospective studies.
METHODS
METHODS
We conducted a prospective cohort study of new pulmonary TB patients with and without DM (TB-DM and TB only) in India. The association of DM with a composite unfavorable TB treatment outcome (failure, recurrence, mortality) over 18 months was determined, and the effect of DM on all-cause mortality and early mortality (death during TB treatment) was assessed.
RESULTS
RESULTS
Of 799 participants, 574 (72%) had TB only and 225 (28%) had TB-DM. The proportion of patients with DM who experienced the composite outcome was 20%, as compared with 21% for TB-only participants (adjusted hazard ratio [aHR], 1.13; 95% CI, 0.75-1.70). Mortality was higher in participants with DM (10% vs 7%), and early mortality was substantially higher among patients with DM (aHR, 4.36; 95% CI, 1.62-11.76).
CONCLUSIONS
CONCLUSIONS
DM was associated with early mortality in this prospective cohort study, but overall unfavorable outcomes were similar to participants without DM. Interventions to reduce mortality during TB treatment among people with TB-DM are needed.
Identifiants
pubmed: 33884278
doi: 10.1093/ofid/ofab097
pii: ofab097
pmc: PMC8047862
doi:
Types de publication
Journal Article
Langues
eng
Pagination
ofab097Subventions
Organisme : FIC NIH HHS
ID : D43 TW009574
Pays : United States
Organisme : NIAID NIH HHS
ID : UM1 AI069465
Pays : United States
Informations de copyright
© The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
Références
Int J Tuberc Lung Dis. 2015 Aug;19(8):879-86
pubmed: 26162352
J Transl Med. 2015 Mar 07;13:83
pubmed: 25880846
Trans R Soc Trop Med Hyg. 2016 Mar;110(3):173-9
pubmed: 26884497
Chest. 2016 Jun;149(6):1501-8
pubmed: 26973015
Am J Trop Med Hyg. 2009 Apr;80(4):634-9
pubmed: 19346391
Eur J Immunol. 2014 Mar;44(3):617-26
pubmed: 24448841
Int J Tuberc Lung Dis. 2017 Dec 1;21(12):1214-1219
pubmed: 29297440
Clin Infect Dis. 2020 Dec 3;71(9):e392-e398
pubmed: 31955202
Sci Transl Med. 2014 Nov 19;6(263):263ra159
pubmed: 25411472
Lancet Infect Dis. 2016 Apr;16(4):e34-46
pubmed: 27036358
PLoS One. 2013 Oct 24;8(10):e77979
pubmed: 24205052
Lancet Diabetes Endocrinol. 2014 Sep;2(9):754-64
pubmed: 25194888
Chest. 2017 Jul;152(1):165-173
pubmed: 28434936
BMC Infect Dis. 2017 Jun 2;17(1):388
pubmed: 28577535
BMC Med. 2011 Jul 01;9:81
pubmed: 21722362
Eur J Clin Microbiol Infect Dis. 2018 Jul;37(7):1259-1263
pubmed: 29679254
BMC Public Health. 2009 Dec 05;9:450
pubmed: 19961618
Braz J Infect Dis. 2017 May - Jun;21(3):312-316
pubmed: 28199824
Lancet Diabetes Endocrinol. 2016 Jan;4(1):8-10
pubmed: 26620249
Clin Infect Dis. 2018 Jan 6;66(2):198-205
pubmed: 29325084
Trop Med Int Health. 2013 Jul;18(7):822-9
pubmed: 23648145
Chest. 2018 Jun;153(6):1347-1357
pubmed: 29253553
Int J Tuberc Lung Dis. 2019 Jul 1;23(7):783-796
pubmed: 31439109
Ann Am Thorac Soc. 2013 Oct;10(5):441-9
pubmed: 23987505
Lancet Infect Dis. 2018 Jul;18(7):e183-e198
pubmed: 29580819
PLoS One. 2017 Nov 21;12(11):e0187967
pubmed: 29161276
Biomed Res Int. 2016;2016:7273935
pubmed: 27642601
Trop Med Int Health. 2010 Nov;15(11):1289-99
pubmed: 20955495
Diabetes Res Clin Pract. 2018 Apr;138:271-281
pubmed: 29496507
Nutr Metab Cardiovasc Dis. 2013 Jan;23(1):17-22
pubmed: 21982361
J Infect. 2017 Jan;74(1):10-21
pubmed: 27717783
Front Public Health. 2016 Jul 07;4:145
pubmed: 27458578
PLoS Med. 2008 Jul 15;5(7):e152
pubmed: 18630984
Int J Tuberc Lung Dis. 2017 Dec 1;21(12):1280-1287
pubmed: 29297449
Nat Rev Nephrol. 2014 Sep;10(9):517-30
pubmed: 25003613
Thorax. 2013 Mar;68(3):214-20
pubmed: 23250998
PLoS One. 2013;8(2):e58044
pubmed: 23469139
Lancet Diabetes Endocrinol. 2014 Sep;2(9):740-53
pubmed: 25194887
Trop Med Int Health. 2010 Nov;15(11):1300-14
pubmed: 20958887