Kumar Rakesh, Singh Urvashi B, Chandra Ankit, Kandasamy Devasenathipathy, Krishnan Anand
Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Am J Trop Med Hyg. 2025 Feb 25;112(5):1065-1071. doi: 10.4269/ajtmh.24-0390. Print 2025 May 7.
This prospective study was done to compare the initial presentation and treatment outcomes of tuberculosis among adult patients who have diabetes mellitus with those without diabetes mellitus. In this study, all adult patients (age 18 years old or older) with microbiologically confirmed drug-sensitive pulmonary tuberculosis who were put on treatment in Ballabgarh block in Haryana were enrolled. Information on clinical, radiological, and microbiological parameters at baseline was obtained by interview or record review. Symptom score was calculated by assigning one point for each symptom from zero to seven. Patients were followed for 6 months from the start of treatment to assess treatment outcomes. Data were analyzed using the χ2 or Fisher exact test. Logistic regression was used to assess the factors associated with death or unfavorable outcomes. In total, 412 patients were included in the study, of which 17.5% had diabetes mellitus. The mean symptom scores among those with and without diabetes were 3.7 (SD 1.3) and 3.6 (SD 1.4), respectively. Treatment success was achieved in 83.6% of patients with diabetes and 86.4% of patients without diabetes. Death was observed in 12.3% of patients with diabetes compared with 7.1% of patients without diabetes. There was no significant difference in clinical presentation, radiology, or sputum smear grade at baseline between patients with or without diabetes. Although treatment success rate was less and death rate was higher in patients with tuberculosis who had diabetes compared with those who did not have diabetes, the difference was not statistically significant.
本前瞻性研究旨在比较成年糖尿病患者与非糖尿病患者结核病的初始表现和治疗结果。在本研究中，纳入了所有在哈里亚纳邦巴拉加尔区接受治疗的微生物学确诊的药物敏感型肺结核成年患者（年龄18岁及以上）。通过访谈或记录审查获取基线时的临床、放射学和微生物学参数信息。症状评分通过对每种症状从0到7分进行赋值计算得出。从治疗开始对患者进行6个月的随访以评估治疗结果。使用χ2检验或Fisher精确检验分析数据。采用逻辑回归评估与死亡或不良结局相关的因素。本研究共纳入412例患者，其中17.5%患有糖尿病。糖尿病患者和非糖尿病患者的平均症状评分分别为3.7（标准差1.3）和3.6（标准差1.4）。糖尿病患者的治疗成功率为83.6%，非糖尿病患者为86.4%。糖尿病患者的死亡率为12.3%，而非糖尿病患者为7.1%。糖尿病患者和非糖尿病患者在基线时的临床表现、放射学表现或痰涂片分级无显著差异。虽然与非糖尿病的结核病患者相比，糖尿病合并结核病患者的治疗成功率较低且死亡率较高，但差异无统计学意义。
