TY - JOUR

T1 - The role of diabetes on the clinical manifestations of pulmonary tuberculosis

AU - Faurholt-Jepsen, Daniel

AU - Range, Nyagosya

AU - PrayGod, George

AU - Jeremiah, Kidola

AU - Faurholt-Jepsen, Maria

AU - Aabye, Martine G.

AU - Changalucha, John

AU - Christensen, Dirk Lund

AU - Krarup, Henrik Bygum

AU - Witte, Daniel R.

AU - Andersen, Aase B

AU - Friis, Henrik

N1 - IHE 2012 041

PY - 2012

Y1 - 2012

N2 - Objective: Diabetes is associated with pulmonary tuberculosis (TB), possibly due to impaired immunity, and diabetes may exacerbate the clinical manifestations of TB. Our aim was to assess the role of diabetes in the clinical manifestations of TB.Methods: We studied 1250 patients with pulmonary TB in an urban population in a cross-sectional study in Tanzania. All participants were tested for diabetes and HIV co-infection, and TB culture intensity was assessed. Levels of white blood cells, haemoglobin, acute phase reactants, CD4 count and HIV viral load were measured, and a qualitative morbidity questionnaire was used to identify theprevalence of disease-related symptoms.Results: Tuberculosis patients with diabetes had a higher neutrophil count (B 0.5 x 10 9 cells/ l, 95% CI 0.2; 0.9, P = 0.001) than non-diabetic TB patients. Serum C-reactive protein (B 18.8 mg / l, CI 95% 8.2; 29.4, P = 0.001) and alpha-1-acid glycoprotein (B 0.2 g / l, CI 95% 0.03; 0.3, P = 0.02) were similarly higher in patients with diabetes. Diabetes did not affect culture intensity or HIV status, but selfreported fever was three times higher among participants with diabetes than in those without diabetes (OR 2.9, CI 95% 1.5; 5.7, P = 0.002).Conclusion: Diabetes is associated with small changes in the manifestations of TB, but may have little clinical signi¿cance.

AB - Objective: Diabetes is associated with pulmonary tuberculosis (TB), possibly due to impaired immunity, and diabetes may exacerbate the clinical manifestations of TB. Our aim was to assess the role of diabetes in the clinical manifestations of TB.Methods: We studied 1250 patients with pulmonary TB in an urban population in a cross-sectional study in Tanzania. All participants were tested for diabetes and HIV co-infection, and TB culture intensity was assessed. Levels of white blood cells, haemoglobin, acute phase reactants, CD4 count and HIV viral load were measured, and a qualitative morbidity questionnaire was used to identify theprevalence of disease-related symptoms.Results: Tuberculosis patients with diabetes had a higher neutrophil count (B 0.5 x 10 9 cells/ l, 95% CI 0.2; 0.9, P = 0.001) than non-diabetic TB patients. Serum C-reactive protein (B 18.8 mg / l, CI 95% 8.2; 29.4, P = 0.001) and alpha-1-acid glycoprotein (B 0.2 g / l, CI 95% 0.03; 0.3, P = 0.02) were similarly higher in patients with diabetes. Diabetes did not affect culture intensity or HIV status, but selfreported fever was three times higher among participants with diabetes than in those without diabetes (OR 2.9, CI 95% 1.5; 5.7, P = 0.002).Conclusion: Diabetes is associated with small changes in the manifestations of TB, but may have little clinical signi¿cance.

U2 - 10.1111/j.1365-3156.2012.03002.x

DO - 10.1111/j.1365-3156.2012.03002.x

M3 - Journal article

C2 - 22574967

VL - 17

SP - 877

EP - 883

JO - Tropical Medicine & International Health

JF - Tropical Medicine & International Health

SN - 1360-2276

IS - 7

ER -