Prevalence of Latent Tuberculosis in Patients with Chronic Kidney Disease of Non Diabetic Origin in Central Sri Lanka

Abstract

Background: Sri Lanka is moderate prevalence of tuberculosis(TB) with goal to end TB by 2030. However, identification of groups at risk of acquiring TB is of particular interest. Latent TB acts as a seedbed for future TB. Chronic kidney disease(CKD) is a non communicable disease of considerable burden due to CKD of unidentified origin which is highly prevalent in certain regions of the country. Methodology: Patients with non diabetic CKD, who were not acutely ill were enrolled for the study. All were screened for symptoms of active tuberculosis and if present, these patients were excluded from the study. Details were collected with an interviewer administeredquestionnaire. Mantaux test was done to identify latent TB. AsCKD is considered to beanimmunocompromised state, a reading of more than 5 mm was considered positive. Data were analysed using SPSS. Results: 77 were enrolled out of which 42 (55%) were male. The mean age of were 47, range 17 – 82. 21 patients (27%) had a positive mantaux and 56 (73%) tested negative. None of the patients had a contact history of TB. 2 patients had a past history of TB and both were treated more than 4 years back. There was no association between stage of CKD and latent TB. Smoking was significantly associated with occurrence of latent TB (p=0.004). Alcohol use was also associated (p=0.001). Conclusion: 27% of patients with CKD had latent TB indicating the importance of screening this group. Smoking and alcohol use was found to be associated with the occurrence of latent TB indicating the importance of discouraging these practices Further studies are required to ascertain the fraction of these patients which progress to active TB