肺与呼吸系统医学

Diabetes Mellitus among Tuberculosis Patients Admitted to the Pulmonary-tuberculosis Ward, Mahosot Hospital, Lao PDR

Abstract

Yathao Paolee, Mayfong Mayxay, Sisouphan Vidhamaly and Vasana Vongvanhdy

Background: Diabetes mellitus (DM) is documented as an important risk factor to tuberculosis (TB). Lao PDR has high TB burden, along with increasing DM prevalence. There are inadequate data on prevalence of DM among TB cases in Lao PDR and lack of data about the effect of DM on treatment outcomes of TB.

Objective: To determine prevalence of DM among TB patients admitted to the Pulmonary Department, Mahosot hospital, Lao PDR, to describe the socio-demographics and others factor associated with TB-DM co-occurrence and to compare the clinical features and treatment outcomes between TB with and without DM patients.

Methods: Using a retrospective design, 199 active TB diagnosed at the Pulmonary-Tuberculoisis Ward, Mahosot Hospital, Lao PDR between February 2015 to August 2016 that met the study criteria were selected. Data regarding socio-demographic characteristics, factors associated with TB-DM co-occurrence, clinical and laboratory parameters, drug susceptibility and treatment outcomes were compared between TB patients with DM and those without DM.

Results: Of the 199 patients, 48 (24.12%) had DM, of which 33 (68.75%) previously diagnosed, 15 (31.25%) new diagnosis at TB diagnosis. On baseline characteristics found that mean age of participating was 52.56 (SD=18.88) years, TB with DM were significantly older than TB  without DM with p=0.007, male patients were more than female (69% vs. 31%), Government staff with TB-DM was higher proportion than those without DM (41.67% vs. 23.84%, p=0.05), patients with family history of DM shown diagnosed DM higher than those without family history of DM (25.00%) vs. 11.26%, p=0.005). While, alcohol consumption and smoking was not significant differed between both groups, weight loss >5% of TB patients with DM was significantly lower than those without DM (25.00% vs 41.06%, p=0.04). TB with DM patients presented cavity on chest radiograph significantly higher than those without DM (91.67% vs 78.15%, p=0.03), sputum AFB conversion at month 2 after treatment shown TB with DM significantly lower than those without DM (43.75% vs. 61.59%, p=0.03). Cured rate of TB with DM patient was significantly lower than TB-non DM (58.33% vs. 74.17%, p=0.036).

Conclusion: Screening for DM in TB patients would help for its early detection and a good control plasma glucose levels to improve the treatment outcomes of TB patients.