Outcome of Tuberculosis Treatment in Patients with Diabetes Mellitus Treated in the Revised National Tuberculosis Control Programme in Malappuram District, Kerala, India
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). To assess, under programme conditions,...
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| Vydáno v: | PloS one Ročník 8; číslo 10; s. e76275 |
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| Médium: | Journal Article |
| Jazyk: | angličtina |
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United States
Public Library of Science
14.10.2013
Public Library of Science (PLoS) |
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| ISSN: | 1932-6203, 1932-6203 |
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| Abstract | 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).
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.
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.
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).
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. |
|---|---|
| AbstractList | 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. 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). 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. 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. 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). 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. 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. SettingsKerala 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).ObjectivesTo 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.DesignThis 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.ResultsDM 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).ConclusionThis 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. 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). 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. 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. 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). 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. 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).SETTINGSKerala 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).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.OBJECTIVESTo 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.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.DESIGNThis 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.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).RESULTSDM 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).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.CONCLUSIONThis 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. |
| Audience | Academic |
| Author | Duraisamy, Karthickeyan Sagili, Karuna D. M, Sunilkumar Balakrishnan, Shibu S, Jaya Sankar KV, Nandakumar MV, Ajay Kumar Enarson, Donald A. Satyanarayana, Srinath |
| AuthorAffiliation | 6 International Union Against Tuberculosis and Lung Disease, Montreal, Quebec, Canada 2 Department of Tuberculosis, WHO Country Office for India, New Delhi, India 1 District Tuberculosis Centre, Manjeri, Malappuram District, Kerala, India 5 International Union Against Tuberculosis and Lung Disease, South East Asia Regional Office, New Delhi, India 3 State TB Training and Demonstration Centre, Trivandrum, Kerala, India Institute of Infectious Diseases and Molecular Medicine, South Africa 4 State TB Cell, Trivandrum, Kerala, India |
| AuthorAffiliation_xml | – name: 3 State TB Training and Demonstration Centre, Trivandrum, Kerala, India – name: Institute of Infectious Diseases and Molecular Medicine, South Africa – name: 2 Department of Tuberculosis, WHO Country Office for India, New Delhi, India – name: 4 State TB Cell, Trivandrum, Kerala, India – name: 1 District Tuberculosis Centre, Manjeri, Malappuram District, Kerala, India – name: 6 International Union Against Tuberculosis and Lung Disease, Montreal, Quebec, Canada – name: 5 International Union Against Tuberculosis and Lung Disease, South East Asia Regional Office, New Delhi, India |
| Author_xml | – sequence: 1 givenname: Nandakumar surname: KV fullname: KV, Nandakumar – sequence: 2 givenname: Karthickeyan surname: Duraisamy fullname: Duraisamy, Karthickeyan – sequence: 3 givenname: Shibu surname: Balakrishnan fullname: Balakrishnan, Shibu – sequence: 4 givenname: Sunilkumar surname: M fullname: M, Sunilkumar – sequence: 5 givenname: Jaya Sankar surname: S fullname: S, Jaya Sankar – sequence: 6 givenname: Karuna D. surname: Sagili fullname: Sagili, Karuna D. – sequence: 7 givenname: Srinath surname: Satyanarayana fullname: Satyanarayana, Srinath – sequence: 8 givenname: Ajay Kumar surname: MV fullname: MV, Ajay Kumar – sequence: 9 givenname: Donald A. surname: Enarson fullname: Enarson, Donald A. |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/24155897$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Copyright | COPYRIGHT 2013 Public Library of Science 2013 KV et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2013 KV et al 2013 KV et al |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Conceived and designed the experiments: NKV KD SB SM JS KDS AMV DAE. Performed the experiments: NKV KD. Analyzed the data: NKV KD KDS AMV DAE. Contributed reagents/materials/analysis tools: NKV KD AMV DAE. Wrote the paper: NKV KDS DAE. Reviewed the manuscript: KD AMV DAE KDS SS. Contributed to discussion: KDS SS AMV DAE. Competing Interests: The authors have declared that no competing interests exist. |
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| References | GW Reed (ref8) 2013; 2 ref14 A Mishra (ref15) 2012; 2 ref17 ref19 MA Baker (ref12) 2011; 1 T Sullivan (ref18) 2012; 7 V Viswanathan (ref6) 2012; 7 BI Restrepo (ref7) 2008; 4 (ref22) 2006; 29 CY Jeon (ref4) 2008; 7 S Balakrishnan (ref16) 2012; 10 MEJ Corona (ref13) 2013; 3 ref24 ref23 ref26 ref25 ref20 ref21 B Alisjahbana (ref10) 2007; 4 ref27 ref9 JDG Fiebert (ref1) 2011; 2 ref3 ref5 KE Dooley (ref11) 2009; 4 C Dye (ref2) 2011; 6 |
| References_xml | – ident: ref3 – volume: 29 start-page: 543 year: 2006 ident: ref22 article-title: Diagnosis and classification of Diabetes Mellitus publication-title: Diabetes care – volume: 1 start-page: 81 year: 2011 ident: ref12 article-title: The impact of diabetes on tuberculosis treatment outcomes: A systematic review publication-title: BMC Medicine 9 doi: 10.1186/1741-7015-9-81 – volume: 3 start-page: 214 year: 2013 ident: ref13 article-title: Association of diabetes and tuberculosis: impact on treatment and post treatment outcomes publication-title: Thorax 68 doi: 10.1136/thoraxjnl-2012-201756 – ident: ref20 – ident: ref25 doi: 10.1111/tmi.12084 – volume: 4 start-page: 428 year: 2007 ident: ref10 article-title: The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis publication-title: Clinical Infectious Diseases 45 doi: 10.1086/519841 – ident: ref24 – volume: 4 start-page: 634 year: 2009 ident: ref11 article-title: Impact of diabetes mellitus on treatment outcomes of patients with active tuberculosis publication-title: The American Journal of Tropical Medicine and Hygiene 80 doi: 10.4269/ajtmh.2009.80.634 – volume: 2 start-page: 01 year: 2012 ident: ref15 article-title: An Association between the poor Glycemic level and severity of Pulmonary Tuberculosis publication-title: G.J.P&ASc and Tech 02 – ident: ref5 doi: 10.1016/S1473-3099(09)70282-8 – volume: 6 start-page: e21161 year: 2011 ident: ref2 article-title: Nutrition, diabetes and tuberculosis in the epidemiological transition publication-title: PloSONE 6 doi: 10.1371/journal.pone.0021161 – ident: ref19 – ident: ref27 doi: 10.1111/j.1365-3156.2010.02632.x – volume: 4 start-page: 541 year: 2008 ident: ref7 article-title: Mycobacterial clearance from sputum is delayed during the first phase of treatment in patients with diabetes publication-title: The American Journal of Tropical Medicine and Hygiene 79 doi: 10.4269/ajtmh.2008.79.541 – ident: ref17 – volume: 2 start-page: 417 year: 2011 ident: ref1 article-title: Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants publication-title: International Journal of Epidemiology 40 doi: 10.1093/ije/dyq238 – volume: 2 start-page: e58044 year: 2013 ident: ref8 article-title: Impact of diabetes and smoking on mortality in tuberculosis publication-title: PLoSONE 8 doi: 10.1371/journal.pone.0058044 – volume: 7 start-page: e41367 year: 2012 ident: ref6 article-title: Prevalence of diabetes and pre-diabetes and associated risk factors among tuberculosis patients in India publication-title: PLoSONE 7 doi: 10.1371/journal.pone.0041367 – volume: 7 start-page: e1001269 year: 2012 ident: ref18 article-title: The co-management of tuberculosis and diabetes: challenges and opportunities in the developing world publication-title: PLoSONE Medicine 9 doi: 10.1371/journal.pmed.1001269 – ident: ref21 – ident: ref23 – ident: ref9 doi: 10.1155/2012/645362 – ident: ref26 doi: 10.1111/tmi.12083 – volume: 10 start-page: e46502 year: 2012 ident: ref16 article-title: High diabetes prevalence among tuberculosis cases in Kerala, India. PLoSone,7 – volume: 7 start-page: e152 year: 2008 ident: ref4 article-title: Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies publication-title: PloS Medicine 5 doi: 10.1371/journal.pmed.0050152 – ident: ref14 |
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| Title | Outcome of Tuberculosis Treatment in Patients with Diabetes Mellitus Treated in the Revised National Tuberculosis Control Programme in Malappuram District, Kerala, India |
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