Relationship Between Clinical, Laboratory, and Radiological Symptoms with The Incidence of Active Pulmonary Tuberculosis in People with Type 2 Diabetes Mellitus

Abstract

Background: Type 2 diabetes mellitus (DM) is an independent risk factor for TB that increases the risk of morbidity and mortality. Method: This research is an observational analytical study using a cross-sectional design, which was conducted at Prof. Ngoerah General Hospital Denpasar, Bali over a 3-year period (January 2019-March 2023). Results: There were 106 samples that met the inclusion criteria consisting of 53 DM-TB subjects and 53 non-TB DM subjects. The results of bivariate analysis showed that there was a significant relationship between cough (PR= 13.67, p= <0.001), weight loss (PR= 3.18, p= <0.001), night sweats (PR= 2.02, p= 0.001), NLR³ 4.76 (PR= 2.53, p= <0.001), MLR³ 0.44 (PR= 2.58, p= <0.001), anemia (PR= 2.26, p= <0.001), uncontrolled HbA1c (PR= 1.65, p= 0.042) with the incidence of active pulmonary TB in people with type 2 DM. The results of multivariate analysis showed that the independent variables consisted of cough (OR= 91.90, p= < 0.001), weight loss (OR= 11.32, p= < 0.001), night sweats (OR= 24.27, p = 0.008), atypical lesions (OR= 2183.74 p= 0.002), typical lesions (OR= 12273.19, p=0.033) affect the incidence of active pulmonary TB in people with type 2 DM. TB scoring results were obtained in people with type 2 DM if suggestive of pulmonary TB if major criteria by adding one or more minor criteria and non-suggestive TB if one or more minor criteria without major criteria. Conclusion: There is a relationship between coughing, night sweats, weight loss, increased NLR, MLR, HbA1c, anemia, typical lesions and atypical lesions with the incidence of active pulmonary TB in people with type 2 DM. TB scoring results were obtained in people with type 2 DM if suggestive of pulmonary TB if major criteria by adding one or more minor criteria and non-suggestive TB if one or more minor criteria without major criteria.