Cavanaugh J, Viney K, Kienene T, Harley D, Kelly P M, Sleigh A, O'Connor J, Mase S
Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia.
Trop Med Int Health. 2015 May;20(5):643-649. doi: 10.1111/tmi.12468. Epub 2015 Feb 18.
To determine the association between diabetes and the clinical features and treatment outcomes of TB in Kiribati.
We enrolled consecutive patients with TB who presented from August 2010 to February 2012 and compared clinical features and TB treatment outcomes for patients with and without diabetes, as measured by haemoglobin A1c assay. Poor outcome was defined as death, default or treatment failure, and good outcome as treatment success or cure.
Two hundred and seventy-five eligible persons with TB disease were enrolled; 101 (37%) had diabetes. TB patients with diabetes were more likely to have acid-fast bacilli (AFB) seen on sputum smear microscopy (RR: 1.3; 95% CI: 1.03-1.62). The risk of poor outcome did not differ between patients with or without diabetes (RR: 1.1; 95% CI: 0.5-2.7).
TB patients with diabetes are more likely than those without to have sputum with AFB on microscopy. This could increase transmission in the community. Early detection of TB by screening patients with diabetes, and the converse, could be important public health interventions where diabetes and TB are prevalent.
确定基里巴斯糖尿病与结核病的临床特征及治疗结果之间的关联。
我们纳入了2010年8月至2012年2月期间连续就诊的结核病患者，比较了通过糖化血红蛋白检测确定的有糖尿病和无糖尿病患者的临床特征及结核病治疗结果。不良结局定义为死亡、失访或治疗失败，良好结局定义为治疗成功或治愈。
共纳入275例符合条件的结核病患者；其中101例（37%）患有糖尿病。糖尿病结核病患者痰涂片显微镜检查更易发现抗酸杆菌（RR：1.3；95%CI：1.03 - 1.62）。有糖尿病和无糖尿病患者的不良结局风险无差异（RR：1.1；95%CI：0.5 - 2.7）。
糖尿病结核病患者比无糖尿病患者在显微镜检查下痰中更易出现抗酸杆菌。这可能增加社区传播。在糖尿病和结核病流行地区，通过筛查糖尿病患者早期发现结核病，反之亦然，可能是重要的公共卫生干预措施。
