Epidemiology and Infection

Original Papers

Tuberculosis

Impact of diabetes on clinical presentation and treatment outcome of pulmonary tuberculosis in Beijing

C. HONGGUANGa1 c1, L. MINa1 c1, J. SHIWENa2, G. FANGHUIa1, H. SHAOPINGa3, G. TIEJIEa4, L. NAa3 and Z. ZHIGUOa4

a1 Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China

a2 National Center for Tuberculosis Control and Prevention, China CDC, Beijing, China

a3 PTB Dispensary of Fangshan District, Beijing, China

a4 PTB Dispensary of Changping District, Beijing, China

SUMMARY

Diabetes mellitus (DM) is currently known to be one of the risk factors for pulmonary tuberculosis (PTB) and the proportion of DM in PTB is rising along with the increased prevalence of DM in countries with high PTB burden. This study was designed to explore the impact of DM on clinical presentation and treatment outcome of PTB in China. In an urban setting in Beijing, 1126 PTB patients, 30·6% with positive sputum smear, registered in two PTB dispensaries from January 2010 to December 2011 were screened for DM and were followed up prospectively during PTB treatment. DM was observed in 16·2% of patients with PTB. PTB with DM appeared to be associated with older age and a higher proportion of re-treatment. On presentation, DM was associated with more severe PTB signs with higher proportions of smear positivity [odds ratio (OR) 2·533, 95% confidence interval (CI) 1·779–3·606], cavity (OR 2·253, 95% CI 1·549–3·276) and more symptoms (OR 1·779, 95% CI 1·176–2·690). DM was also associated with non-TB deaths (OR 5·580, 95% CI 2·182–14·270, P < 0·001) and treatment failure (OR 6·696, 95% CI 2·019–22·200, P = 0·002). In Beijing, the findings of this study underlined the need to perform early bi-directional screening programmes and explore the underlying mechanism for different treatment outcomes for PTB with DM.

(Received July 06 2013)

(Revised February 14 2014)

(Accepted March 15 2014)

(Online publication April 09 2014)

Key words

  • Infectious disease control;
  • infectious disease epidemiology;
  • tuberculosis (TB)

Correspondence

c1 Author for correspondence: L. Min, MD, PhD, or C. Hongguang, MD, PhD, Department of Epidemiology and Biostatistics, Peking University, Beijing, 100191, People's Republic of China. (Email: liumin@bjmu.edu.cn) [L. Min] (Email: chenhg@bjmu.edu.cn) [C. Hongguang]

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