Prevalence and factors associated with diabetes mellitus among tuberculosis patients in South India-a cross-sectional analytical study.


Journal

BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874

Informations de publication

Date de publication:
22 10 2021
Historique:
entrez: 23 10 2021
pubmed: 24 10 2021
medline: 4 11 2021
Statut: epublish

Résumé

To determine the prevalence and determinants of diabetes mellitus (DM) among tuberculosis (TB) patients and to assess the additional yield and number needed to screen (NNS) to obtain a newly diagnosed DM among TB patients. We undertook a cross-sectional analysis of the cohort data under Regional Prospective Observational Research for Tuberculosis-India consortium. Newly diagnosed TB patients recruited into the cohort between 2014 and 2018 were included. Pretested standardised questionnaires and tools were used for data collection. Prevalence of DM among TB patients was summarised as proportion with 95% CI. Type II DM was diagnosed if random blood sugar level was >200 mg/dL or if the participant had a documented history of DM. NNS by blood glucose testing to diagnose one new DM case among TB patients was also calculated. Three districts of South India: Puducherry, Cuddalore and Villupuram SUBJECTS: Newly diagnosed sputum smear positive pulmonary TB patients aged ≥16 years RESULTS: In total, 1188 TB patients were included. Prevalence of DM among TB patients was 39% (95% CI: 36.2% to 41.8%). In unadjusted analysis, elderly TB, marital status, caste, gender, higher education level, household income and obesity had a significant association with DM. However, in adjusted analysis, only marital status (currently married aPR; 3.77 (95 CI: 2.20 to 6.49), widowed/separated/divorced aPR; 3.66 (95 CI: 1.96 to 6.83)) and body mass index category (normal weight aPR; 3.26 (95 CI: 2.55 to 4.16), overweight aPR; 3.86 (95 CI: 2.69 to 5.52), obesity aPR; 4.08 (95 CI: 2.81 to 5.94)) were found to be significant determinants. The number of TB patients needed to be screened to find a new DM case was 12. We found that one in three TB patients had coexisting DM. The number of TB patients needed to be screened to obtain a newly diagnosed DM patients was also determined. The study supports and highlights the need of RNTCP's effort in bidirectional screening of TB and DM.

Identifiants

pubmed: 34686553
pii: bmjopen-2021-050542
doi: 10.1136/bmjopen-2021-050542
pmc: PMC8543642
doi:

Types de publication

Journal Article Observational Study Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e050542

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

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Auteurs

Sathish Rajaa (S)

Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India.

Yuvaraj Krishnamoorthy (Y)

Jawaharlal Institute of Postgraduate Medical Education, Puducherry, India yuvi.1130@gmail.com.

Selby Knudsen (S)

Department of Infectious Diseases, Boston Medical Center, Boston, Massachusetts, USA.

Gautam Roy (G)

Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, Puducherry, India.

Jerrold Ellner (J)

Department of Medicine, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

C Robert Horsburgh (CR)

Boston University, Boston, Massachusetts, USA.

Natasha S Hochberg (NS)

Section of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.

Padmini Salgame (P)

Rutgers University Newark, Newark, New Jersey, USA.

Govindarajan S (G)

Directorate of Health Services, State TB cell, Puducherry, India.

Senbagavalli Prakash Babu (S)

Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, Puducherry, India.

Sonali Sarkar (S)

Department of Preventive and Social Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, Puducherry, India.

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