Abstract
BackgroundMany elements have been studied repeatedly that influence time to sputum culture conversion in multi-drug resistant tuberculosis (MDR-TB). Deranged sugars not only hamper one’s infection contesting ability but also increase the chances of drug resistance. Our aim was to establish whether or not glycemic control alters MDR-TB treatment outcome.MethodsA prospective cohort study was conducted at the TB Clinic of Jinnah Postgraduate Medical Center, Karachi, Pakistan. Newly diagnosed MDR-TB cases were started on WHO-recommended treatment regime. HbA1c (hemoglobin A1c or glycated hemoglobin) was tested at the start of treatment irrespective of the previous diabetic status. Sputum samples, 30 days apart, were taken during the initial phase of the MDR TB treatment until two consecutive samples showed conversion. Pearson's correlation coefficient was calculated to see the link between time to sputum culture conversion and HbA1c.ResultsAmong 47 patients, 19 (40.4%) new cases, whereas 28 (59.8%) were previously treated for drug-sensitive TB. Our 39 patients converted during six months, of which 18 (46%) converted in one month, 14 (35.9%) in two months, 6 (15.4%) in three months, and only 1 in five months. Mean time to sputum culture conversion was 1.77 ± 0.9 months. There was a slightly negative correlation between HbA1c and sputum culture conversion time (r = -0.075, p = 0.649).ConclusionsSugar control does not affect sputum culture conversion in MDR-TB when an optimal treatment regime is applied.
Highlights
Tuberculosis (TB) remains one of the leading infectious causes of morbidity and mortality worldwide [1]
Diagnosed multidrug resistant tuberculosis (MDR-TB) cases were started on WHO-recommended treatment regime
Pearson's correlation coefficient was calculated to see the link between time to sputum culture conversion and HbA1c
Summary
Tuberculosis (TB) remains one of the leading infectious causes of morbidity and mortality worldwide [1]. Drug-resistant TB (DR-TB) is a major challenge to national TB control programs (NTPs) [2]. In 2018, there were an estimated 484,000 incident DR-TB patients worldwide. Pakistan is among the world's high-burden countries for drug-susceptible (DS) and DR-TB, with an estimated 28,000 new DR-TB patients (4.2% and 16% of new and re-treatment patients, respectively) in 2018. The treatment success rate for DR-TB in Pakistan was 64% in 2018, which is higher than the global treatment success rate (56%) [3]. The 2016 Global Diabetes Report stated that 422 million people were affected by DM [4]. A recent study estimated that by 2030 Pakistan will have the fifth largest number of type 2 DM patients [5]. Many elements have been studied repeatedly that influence time to sputum culture conversion in multidrug resistant tuberculosis (MDR-TB). Our aim was to establish whether or not glycemic control alters MDR-TB treatment outcome
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