IMPACT OF DIABETES MELLITUS ON TREATMENT OUTCOME OF MULTIDRUG RESISTANT PULMONARY TUBERCULOSIS
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 22
Abstract
BACKGROUND Multiple studies have indicated that patients of pulmonary tuberculosis with diabetes mellitus may experience poor outcome. Emergence of Multidrug Resistant-TB has further complicated the situation, as its management may be challenging in presence of diabetes. There is a paucity of data on effect of diabetes on outcome of MDR-TB in Indian context. The study aimed to assess the effect of Diabetes Mellitus on mean time for sputum culture conversion and treatment outcome in patients of Multidrug Resistant Pulmonary Tuberculosis. MATERIALS AND METHODS The present observational cross-sectional study was conducted at Drug Resistant-TB centre, SRN Hospital, MLN Medical College, Allahabad. 144 diagnosed patients of MDR-TB were treated with Category IV DOTS and were retrospectively analysed for the effect of DM as a comorbidity on their outcome on treatment completion. The diagnosis of Diabetes Mellitus and treatment outcomes were defined as per WHO guidelines. RESULTS Out of 144 MDR-TB patients, 13 (9.03%) had co-existing Diabetes Mellitus. Patients having MDR-TB with Diabetes had longer sputum culture conversion time (131.4 ± 40.99 vs. 118.72 ± 41.54 days, p= 0.358) compared to MDR-TB patients without diabetes. They also had 2.75 times higher odds of death than patients in non-diabetic group (53.85% vs. 30.47%, 95% confidence interval [CI] 0.869 to 8.717). Non-diabetics had 1.84 times higher odds of culture negativity at 6 months (54.26% vs. 38.46%, CI=0.57 to 5.91) and 1.73 times odds of successful treatment (44.53% vs. 30.77%, CI= 0.51 to 5.91) compared to diabetic patients. 12.5% patients defaulted on treatment in non-diabetic group, while diabetic group had no default. 15.38% patients failed treatment in diabetic group compared to 12.5% in non-diabetic group (p= 0.667). Outcome of 3 patients was not known, since they were transferred out. CONCLUSION Diabetes Mellitus as a comorbidity was associated with longer culture conversion time, decreased success rate, higher treatment failure and higher death rate among patients of MDR-TB, but the results were not found to be statistically significant which may be due to small sample size in the MDR-TB with diabetes group.
Authors and Affiliations
Tariq Mahmood, Arvind Kumar Verma, Kaleem Ahmad, Sachi Satpathy, Abida Akmal, Ashish Kumar Gutpa
Keywords
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- EP ID EP433347
- DOI 10.14260/jemds/2018/602
- Views 74
- Downloads 0
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