Abstract
IntroductionMulti-drug-resistant tuberculosis (MDR-TB) has emerged as a challenge to global tuberculosis (TB) control and remains a major public health concern in many countries. Diabetes mellitus (DM) is an increasingly recognized comorbidity that can both accelerate TB disease and complicate its treatment. The aim of this study is to summarize available evidence on the association of DM and MDR-TB among TB patients and to provide a pooled estimate of risks.MethodsAll studies published in English before October 2016 will be searched using comprehensive search strings through PubMed, EMBASE, Web of Science, and WHO Global Health Library databases which have reported the association of DM and MDR-TB in adults with TB (age > =15). Two authors will independently collect detailed information using structured data abstraction form. The quality of studies will be checked using Newcastle-Ottawa Scale for cohort and case-control studies and the Agency for Healthcare Research and Quality tool for cross-sectional studies. Heterogeneity between included studies will be assessed using the I2 statistic. We will check potential publication bias by visual inspection of the funnel plot and Egger’s regression test statistic. We will use the random effects model to compute a pooled estimate.DiscussionIncreases in the burden of non-communicable diseases and aging populations are changing the importance of different risk factors for TB, and the profile of comorbidities and clinical challenges for people with TB. Although classic risk factors and comorbidities such as overcrowding, under-nutrition, silicosis, and HIV infection are crucial to address, chronic conditions like diabetes are important factors that impair host defenses against TB. Thus, undertaking integrated multifaceted approach is remarkably necessary for reducing the burden of DM and successful TB treatment outcome.Systematic review registrationPROSPERO CRD42016045692.
Highlights
Multi-drug-resistant tuberculosis (MDR-TB) has emerged as a challenge to global tuberculosis (TB) control and remains a major public health concern in many countries
Three case-control studies comparing Diabetes mellitus (DM)/TB and non-diabetic TB patients from Iran, Saudi Arabia, and Turkey showed no significant association between DM and the risk of MDR-TB [16,17,18]
Increases in the burden of non-communicable diseases and aging populations are changing the importance of different risk factors for TB
Summary
Multi-drug-resistant tuberculosis (MDR-TB) has emerged as a challenge to global tuberculosis (TB) control and remains a major public health concern in many countries. It is an infectious disease caused by strains of mycobacterium TB that are resistant to at least isoniazid and rifampicin [1]. Estimated new TB cases with MDR-TB were 34% in Belarus and 26% in both Kazakhstan and Kyrgyzstan [3]. The estimated re-treatment TB cases with MDR-TB were as high as 69% in Belarus and 58% in Kazakhstan [3]. It is estimated that 99,000 cases of MDR-TB
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
