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

PLoS One. 2013 Oct 14;8(10):e76275. doi: 10.1371/journal.pone.0076275. eCollection 2013.

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.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adult
  • Demography
  • Diabetes Complications / epidemiology*
  • Female
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • National Health Programs* / statistics & numerical data
  • Treatment Outcome
  • Tuberculosis / complications
  • Tuberculosis / drug therapy*
  • Tuberculosis / epidemiology
  • Tuberculosis / prevention & control*

Grant support

Funding for the operational research course was made possible by the support of the American People through the United States Agency for International Development (USAID). Funders had no role in study design, data collection, analysis or interpretation of data. The contents of this paper do not necessarily reflect the views of USAID or the United States Government.