PURPOSE: To determine the prevalence of thoracic complications among pulmonary tuberculosis and diabetes patients in comparison with patients with tuberculosis alone.
METHODS: This study was a cross-sectional survey based on the retrospective analysis of data of tuberculosis subjects in diabetic and not diabetic patients. The study was conducted at Clinic of Tuberculosis of National Institute of Respiratory Diseases (INER), Mexico.
RESULTS: One hundred and sixteen tuberculosis patients were included from july to December of 2003. Fifty-two cases of diabetes mellitus were identified among 116 tuberculosis patients, prevalence: 44.8%. Of 116 patients, 56 (48.3%) were males, with a ratio male:female of 0.93. Of 116 patients 91.4% have bacteriological confirmation. Of 116 patients (92/116) 79.3% have from 0 to 5 years from diagnosis of tuberculosis. The tuberculosis and diabetes patients were older than tuberculosis patients (mean [+ or -] SD 52.38 [+ or -] 11.35 versus 40.70 [+ or -] 16.55 p <.0001). Complications among diabetics or no diabetics patients were: bronchiectasis (96.2% versus 80.9%, p =.01); pneumonia (9.6% versus 1.6%, p=.05); pneumonia by Mycobacterium tuberculosis (7.7% versus 1.6%, p =.1) and hemoptysis (34.6% versus 29.7% p =.6). In multivariate analysis diabetes mellitus was associated to older age (OR= 1.06 years [CI95% 1.02-1.10] p <.0001) and to the presence of bronchiectasis (OR= 13.95 [CI95% 1.84-105] p =.01), controlling by crowding, pneumonia, empiema, hemoptysis and time since tuberculosis diagnosis.
CONCLUSION: The increased risk of bonchiectasies and pneumonia among patients with diabetes and tuberculosis suggest the difficulty of the host in the infection control. One of two tuberculosis patients was diabetics at INER.
CLINICAL IMPLICATIONS: It is necessary to do bacteriological and clinical surveillance for pulmonary tuberculosis among diabetic patients and clinical and metabolic surveillance for diabetes among tuberculosis patients with the purpose to prevent sequels and deaths due to tuberculosis.
DISCLOSURE: Ma Cecilia Garcia-Sancho, None.
Ma Cecilia Garcia-Sancho MS * Enrique L. Segundo MD Rafael V. Vazquez MS Alfredo Torres MD Manuel Castillejos MS Miguel Angel Salazar Lezama MD National Institute of Respiratory Diseases, Mexico, Mexico
COPYRIGHT 2005 American College of Chest Physicians
COPYRIGHT 2005 Gale Group