Viswanathan Vijay, Vigneswari A, Selvan K, Satyavani K, Rajeswari R, Kapur Anil
M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Education, Research and Training in Diabetes), Royapuram, Chennai, India.
M.V. Hospital for Diabetes and Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Education, Research and Training in Diabetes), Royapuram, Chennai, India.
J Diabetes Complications. 2014 Mar-Apr;28(2):162-5. doi: 10.1016/j.jdiacomp.2013.12.003. Epub 2013 Dec 24.
To assess the effect of diabetes on tuberculosis (TB) treatment outcome and sputum conversion among new smear-positive (NSP) cases registered under Directly Observed Treatment Short Course in South India.
Details on sputum conversion and TB treatment outcome were collected from case records of NSP cases (N = 332; M/F 247:85) registered at TB units of three districts in Tamil Nadu. Subjects were screened for diabetes and categorized as diabetic (TBDM) (n = 96; 73:23) and non-diabetic (TBnonDM) (n = 149; 109:40).
Among 245 selected TB patients, 93.5% were cured, 1.6% completed TB treatment, 2% had TB treatment failure (TF), and 0.4% had treatment default (TD), 0.4% with MDR-TB and 2% death rate. At the end of intensive phase of TB treatment, 14.7% remained sputum positive in the TBDM group, whereas it was 3.5% in the TBnonDM group. Mean duration (days) for sputum conversion was higher in the TBDM group (64.2 ± 10.5) compared to the TBnonDM group (61.5 ± 7.5) (p<0.001). TF rate was higher (4.2% vs 0.7%) and MDR-TB (1%) was also seen in the TBDM group. No death and TD were seen among DM whereas it was 3.4 and 0.7% in TBnonDM.
Delayed sputum conversion and high TB treatment failure rates were common in NSP cases with diabetes.
评估糖尿病对印度南部在直接观察下短程治疗登记的新涂片阳性（NSP）病例的结核病（TB）治疗结果和痰菌转阴的影响。
从泰米尔纳德邦三个地区结核病防治单位登记的NSP病例（N = 332；男/女247:85）的病例记录中收集痰菌转阴和结核病治疗结果的详细信息。对受试者进行糖尿病筛查，并分为糖尿病组（TBDM）（n = 96；73:23）和非糖尿病组（TBnonDM）（n = 149；109:40）。
在245例选定的结核病患者中，93.5%治愈，1.6%完成结核病治疗，2%治疗失败（TF），0.4%中断治疗（TD），0.4%为耐多药结核病，死亡率为2%。在结核病治疗强化期结束时，TBDM组14.7%痰菌仍为阳性，而TBnonDM组为3.5%。TBDM组痰菌转阴的平均持续时间（天）（64.2±10.5）高于TBnonDM组（61.5±7.5）（p<0.001）。TBDM组的TF率更高（4.2%对0.7%），耐多药结核病（1%）也更多见。糖尿病患者中未见死亡和中断治疗情况，而TBnonDM组分别为3.4%和0.7%。
糖尿病NSP病例中痰菌转阴延迟和结核病治疗失败率高很常见。
