Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Oct 14;8(10):e76275.
doi: 10.1371/journal.pone.0076275. eCollection 2013.

Outcome of tuberculosis treatment in patients with diabetes mellitus treated in the revised national tuberculosis control programme in Malappuram District, Kerala, India

Nandakumar K V  1 , Karthickeyan Duraisamy, Shibu Balakrishnan, Sunilkumar M, Jaya Sankar S, Karuna D Sagili, Srinath Satyanarayana, Ajay Kumar M V, Donald A Enarson
Affiliations

Outcome of tuberculosis treatment in patients with diabetes mellitus treated in the revised national tuberculosis control programme in Malappuram District, Kerala, India

Nandakumar K V et al. PLoS One. .

Abstract

Settings: Kerala State, India has reported the greatest dual burden of Tuberculosis (TB) and Diabetes Mellitus (DM). Malappuram district in Kerala has monitored and recorded DM status and its control from 2010 under Revised National Tuberculosis Control Program (RNTCP).

Objectives: To assess, under programme conditions, comprehensiveness of recording DM status among TB cases and the TB treatment outcomes among DM patients (disaggregated by glycemic control) and compare with-non DM patients.

Design: This retrospective record review included 3,116TB patients from April 2010 to September 2011.DM was defined as per international guidelines and TB treatment outcomes were categorized as favourable(cured and treatment completed) and unfavourable(death, default, failure and transfer out). Relative Risk (RR) and 95% confidence intervals(CI) were calculated to assess the risk of unfavourable outcomes.

Results: DM status was recorded in 90% of TB cases and 667 (24%) had DM. 17% of DM patients and 23% of patients with unknown DM status had unfavourable outcomes but this difference was not statistically significant. Unadjusted RR for poor glycemic control or unknown control status for unfavourable outcome were (2.00; 95% CI 0.97-4.13) and (2.14; 95% CI 1.11-4.13).

Conclusion: This study could not confirm an adverse association between DM or its control during treatment and the course of response to TB treatment.DM screening in TB cases and recording of DM care needs to be improved to enable more conclusive evidence.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Tuberculosis patients with diabetes and diabetes control.
Figure shows flow of Tuberculosis patients registered under the Revised National Tuberculosis Control Programme (RNTCP) in Malappuram District, Kerala, India, from April 2010 to September 2011, by diabetes and diabetes control status. Out of 3116 TB patients, 2794(90%) know their diabetic status and of this 667(24%) are diabetic. Out of the diabetic TB patients 240(36%) know their diabetic control status during treatment and of this 103(43%) are under diabetic control during treatment.
See this image and copyright information in PMC

References

    1. Fiebert JDG, Jeon CY, Cohen T, Murray MB (2011) Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants. International Journal of Epidemiology 40 2: 417–428. - PMC - PubMed
    1. Dye C, Bourdin B, Lönnroth TK, Roglic G, Williams BG (2011) Nutrition, diabetes and tuberculosis in the epidemiological transition. PloSONE 6 6: e21161. - PMC - PubMed
    1. Sen T, Joshi SR, Udwadia ZF (2009) Tuberculosis and Diabetes Mellitus: Merging Epidemics. JAPI 57,399–404. - PubMed
    1. Jeon CY, Murray MB (2008) Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PloS Medicine 5 7: e152. - PMC - PubMed
    1. Dooley KE, Chaisson RE (2009) Tuberculosis and diabetes mellitus: convergence of two epidemics. The Lancet Infectious Diseases 9, 737–746. - PMC - PubMed

Publication types