Ahmad Siti Rohana, Yaacob Nor Azwany, Jaeb Mat Zuki, Hussin Zalmizy, Wan Mohammad Wan Mohd Zahiruddin
Department of Community Medicine, Universiti Sains Malaysia, Kelantan, Malaysia.
Respiratory Clinic, Hospital Raja Perempuan Zainab, Kelantan, Malaysia.
Iran J Public Health. 2020 Aug;49(8):1485-1493. doi: 10.18502/ijph.v49i8.3892.
There is growing evidence that DM may play an important role in the occurrence of unsuccessful TB treatment outcomes. This study was undertaken to examine the prevalence of DM among TB population, compare the profile of TB patients with and without DM and determine the effect of DM on unsuccessful treatment outcomes among TB patients in Kelantan state, Malaysia from 2012 to 2016.
A cross sectional study was conducted in Sep 2017 using data from registered TB cases in Kelantan state, Malaysia from 2012 to 2016. The profile of TB patients with and without DM were compared in univariable analysis. Multiple logistic regression was used to determine association between DM and unsuccessful treatment outcomes.
A total of 1854 TB patients were diagnosed with DM. The annual proportion was ranging from 26 to 29%. TB patients with DM had an older age, live single, low educational status, poor chest x ray finding and diagnosed with smear positive sputum compared to TB patients without DM. TB patients with DM had three times higher risk to develop unsuccessful TB treatment outcomes compared to TB patients without DM (95% CI 2.47-3.58; = 0.012) in multivariable analysis.
Those with DM had the worst prognosis of TB outcomes among the significant risk factors. TB control program in Malaysia will need to expand efforts to focus on treatment of TB-DM patients to improve their cure rates in order to achieve the goals of tuberculosis elimination.
越来越多的证据表明，糖尿病可能在结核病治疗效果不佳的发生中起重要作用。本研究旨在调查马来西亚吉兰丹州结核病患者中糖尿病的患病率，比较有糖尿病和无糖尿病的结核病患者的特征，并确定2012年至2016年糖尿病对结核病患者治疗效果不佳的影响。
2017年9月进行了一项横断面研究，使用了马来西亚吉兰丹州2012年至2016年登记结核病病例的数据。在单变量分析中比较了有糖尿病和无糖尿病的结核病患者的特征。采用多因素logistic回归分析确定糖尿病与治疗效果不佳之间的关联。
共有1854例结核病患者被诊断为糖尿病。年比例在26%至29%之间。与无糖尿病的结核病患者相比，有糖尿病的结核病患者年龄较大、单身、教育程度低、胸部X光检查结果差且痰涂片阳性。在多变量分析中，与无糖尿病的结核病患者相比，有糖尿病的结核病患者出现治疗效果不佳的风险高出三倍（95%CI 2.47-3.58；P = 0.012）。
在重要的危险因素中，糖尿病患者的结核病预后最差。马来西亚的结核病控制项目需要加大力度，重点关注结核病合并糖尿病患者的治疗，以提高其治愈率，从而实现消除结核病的目标。
