TY - JOUR

T1 - Diabetes is a risk factor for pulmonary tuberculosis

T2 - a case-control study from Mwanza, Tanzania

AU - Faurholt-Jepsen, Daniel

AU - Range, Nyagosya

AU - PrayGod, George

AU - Jeremiah, Kidola

AU - Faurholt-Jepsen, Maria

AU - Aabye, Martine Grosos

AU - Changalucha, John

AU - Christensen, Dirk Lund

AU - Pipper, Christian Bressen

AU - Krarup, Henrik

AU - Witte, Daniel Rinse

AU - Andersen, Aase Bengård

AU - Friis, Henrik

PY - 2011

Y1 - 2011

N2 - Background Diabetes and TB are associated, and diabetes is increasingly common in low-income countries where tuberculosis (TB) is highly endemic. However, the role of diabetes for TB has not been assessed in populations where HIV is prevalent. Methods A case-control study was conducted in an urban population in Tanzania among culture-confirmed pulmonary TB patients and non-TB neighbourhood controls. Participants were tested for diabetes according to WHO guidelines and serum concentrations of acute phase reactants were measured. The association between diabetes and TB, and the role of HIV as an effect modifier, were examined using logistic regression. Since blood glucose levels increase during the acute phase response, we adjusted for elevated serum acute phase reactants. Results Among 803 cases and 350 controls the mean (SD) age was 34.8 (11.9) and 33.8 (12.0) years, and the prevalence of diabetes was 16.7% (95% CI: 14.2; 19.4) and 9.4% (6.6; 13.0), respectively. Diabetes was associated with TB (OR 2.8, 95% CI: 1.04; 7.67, p=0.04). However, the association depended on HIV status (p=0.01) due to a stronger association among HIV uninfected (OR 4.2, 95% CI: 1.5; 11.6, p=0.01) compared to HIV infected (OR 0.1, 95% CI: 0.01; 1.8, p=0.13) after adjusting for age, sex, demographic factors and elevated serum acute phase reactants. Conclusion Diabetes is a risk factor for TB in HIV uninfected, whereas the association in HIV infected patients needs further study. The increasing diabetes prevalence may be a threat to TB control.

AB - Background Diabetes and TB are associated, and diabetes is increasingly common in low-income countries where tuberculosis (TB) is highly endemic. However, the role of diabetes for TB has not been assessed in populations where HIV is prevalent. Methods A case-control study was conducted in an urban population in Tanzania among culture-confirmed pulmonary TB patients and non-TB neighbourhood controls. Participants were tested for diabetes according to WHO guidelines and serum concentrations of acute phase reactants were measured. The association between diabetes and TB, and the role of HIV as an effect modifier, were examined using logistic regression. Since blood glucose levels increase during the acute phase response, we adjusted for elevated serum acute phase reactants. Results Among 803 cases and 350 controls the mean (SD) age was 34.8 (11.9) and 33.8 (12.0) years, and the prevalence of diabetes was 16.7% (95% CI: 14.2; 19.4) and 9.4% (6.6; 13.0), respectively. Diabetes was associated with TB (OR 2.8, 95% CI: 1.04; 7.67, p=0.04). However, the association depended on HIV status (p=0.01) due to a stronger association among HIV uninfected (OR 4.2, 95% CI: 1.5; 11.6, p=0.01) compared to HIV infected (OR 0.1, 95% CI: 0.01; 1.8, p=0.13) after adjusting for age, sex, demographic factors and elevated serum acute phase reactants. Conclusion Diabetes is a risk factor for TB in HIV uninfected, whereas the association in HIV infected patients needs further study. The increasing diabetes prevalence may be a threat to TB control.

U2 - 10.1371/journal.pone.0024215

DO - 10.1371/journal.pone.0024215

M3 - Journal article

C2 - 21912626

VL - 6

SP - e24215

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 8

ER -