Therapeutic Outcome of Pulmonary Tuberculosis in Type-2 Diabetes Patients

  • Muhammad Kashif Munir Research Officer, Pakistan Health Research Council, TB Research Centre, KEMU, Lahore
  • Muhammad Adnan Pakistan Health Research Council, Research Centre, Fatima Jinnah Medical University, Lahore
  • Iffat Shabbir Pakistan Health Research Council, Research Centre, Fatima Jinnah Medical University, Lahore
  • Tayyaba Rahat Pakistan Health Research Council, Research Centre, Fatima Jinnah Medical University, Lahore
  • Sana Rehman Research Officer, Pakistan Health Research Council, TB Research Centre, KEMU, Lahore
Keywords: Therapeutics outcome, MDR, TB with diabetes, glycemic control

Abstract

Objective: Tuberculosis is a major cause of morbidity and mortality and diabetes is a leading risk factor of tuberculosis. Co-existence of tuberculosis and diabetes may increase the disease severity and worsen the treatment outcome. Therefore, objective is to find the anti-tuberculosis treatment outcome among pulmonary tuberculosis patients with or without diabetes mellitus; and to see the drug resistance pattern among treatment failure cases in both groups. Methodology: The cross-sectional study was carried out at PHRC Research Center FJMU Lahore in collaboration with PHRC TB Research Centre KEMU Lahore during the year 2013-14. The data of 268 patients including 187 pulmonary tuberculosis patients without diabetes and 81 with diabetes was analyzed. Anti-tuberculosis treatment according to current guidelines of Directly Observed Therapy (DOT) was provided to all patients; and were assessed for improvement of AFB smear; AFB culture and Chest X-Ray before and after four months of starting ATT. Data were analyzed by using Statistical Package for Social Sciences version 20. Results: Mean age of non-diabetic TB patients was 36±16 years; and of diabetic TB patients was 50±12 years. Mean duration of diabetes was 6±4 years. Other characteristics included 57.8% males, 42.2% females, and 53.7% had history of contact. Cough, expectoration, fever and weight loss were commonly occurring symptoms. Infiltration (76.1%) was the commonest type of lesion followed by consolidation (14.6%) and cavitation (9.3%). Findings of AFB Smear conversion, AFB Culture, and Chest X-ray were improved with time in both groups; and rates of improvement were significantly higher among non-diabetic TB patients (p <0.05). The frequency of drug resistance was lower among non-diabetic TB patients (7.0% vs. 19.8%) but the difference was insignificant. The rates of drug resistance and MDR were considerably higher among patients with poor glycemic control (p 0.036). Conclusion: Therapeutic outcome of pulmonary tuberculosis was poor among diabetic TB patients as compare to non-diabetic TB patients. Therefore, along with anti-tuberculosis treatment, improvement of glycemic control must be considered among diabetic TB patients for better treatment outcome and reduced drug resistance rate.

Published
2018-04-14
How to Cite
Munir, M., Adnan, M., Shabbir, I., Rahat, T., & Rehman, S. (2018). Therapeutic Outcome of Pulmonary Tuberculosis in Type-2 Diabetes Patients. Annals of Punjab Medical College (APMC), 12(2), 98-102. https://doi.org/10.29054/apmc/2018.120