Abstract
BackgroundDespite increasing reports of the linkage between diabetes and tuberculosis (TB), there is limited information regarding diabetes and TB drug resistance.MethodsIn this cross-sectional study, sputum and blood samples were collected from 304 adult patients in rural Andhra Pradesh. Rifampin resistance was assessed by Xpert MTB/RIF (Xpert), and diabetes status was based on self-report. Additionally, samples were assayed by acid-fast bacilli sputum smear microscopy (AFB) and QuantiFERON-TB Gold In-Tube (QFT-G), in order to compare relative diagnostic performances.ResultsAmong patients with confirmed TB (n = 194), diabetes was associated with 3.0-fold higher risk of rifampin resistance (95 % CI 1.3–6.7). Considering Xpert MTB/RIF the gold standard, AFB had lower sensitivity (72.2 vs. 82.5 %) and higher specificity (96.4 vs. 37.0 %) compared to QFT-G for diagnosing TB.ConclusionsThe increased risk of rifampin resistance in patients with diabetes highlights the need for integrated diabetes surveillance in TB programs, particularly in settings undergoing the epidemiological transition.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-1204-5) contains supplementary material, which is available to authorized users.
Highlights
Despite increasing reports of the linkage between diabetes and tuberculosis (TB), there is limited information regarding diabetes and TB drug resistance
Among 304 study participants with suspected TB, 63.8 % had TB confirmed by Xpert MTB/RIF (Xpert), 10.9 % had diabetes, and 2.6 % were living with Human immunodeficiency virus (HIV) (Table 1)
Rifampin resistance was associated with diabetes, previous TB treatment, and positive acid-fast bacilli sputum smear microscopy (AFB) (Table 2)
Summary
Despite increasing reports of the linkage between diabetes and tuberculosis (TB), there is limited information regarding diabetes and TB drug resistance. The synergistic interactions between diabetes and tuberculosis (TB) are widely recognized [1]. Studies among patients with TB report associations between diabetes and adverse outcomes, including mortality, TB treatment failure and relapse [2]. Diabetes is associated with a 3-fold increased risk of active TB, according to a systematic review [3]. TB drug resistance is a growing challenge to improving TB control; estimates show 480,000 incident cases of multidrug-resistant TB (MDR-TB) in 2013 [4]. In 2013, over 50 % of MDR-TB cases were reported in India, China, and the Russian Federation [4]. The treatment success rate of MDRTB (48 %) is significantly lower than that among new TB cases (86 %) [4]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
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 callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
