scholarly journals Prevalence and factors associated with diabetes mellitus among tuberculosis patients in South India—a cross-sectional analytical study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e050542
Author(s):  
Sathish Rajaa ◽  
Yuvaraj Krishnamoorthy ◽  
Selby Knudsen ◽  
Gautam Roy ◽  
Jerrold Ellner ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Marital Status ◽  
South India ◽  
Normal Weight ◽  
Observational Research ◽  
Sputum Smear ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Glucose Testing ◽  
Number Needed To Screen

ObjectiveTo determine the prevalence and determinants of diabetes mellitus (DM) among tuberculosis (TB) patients and to assess the additional yield and number needed to screen (NNS) to obtain a newly diagnosed DM among TB patients.DesignWe undertook a cross-sectional analysis of the cohort data under Regional Prospective Observational Research for Tuberculosis-India consortium. Newly diagnosed TB patients recruited into the cohort between 2014 and 2018 were included. Pretested standardised questionnaires and tools were used for data collection. Prevalence of DM among TB patients was summarised as proportion with 95% CI. Type II DM was diagnosed if random blood sugar level was >200 mg/dL or if the participant had a documented history of DM. NNS by blood glucose testing to diagnose one new DM case among TB patients was also calculated.SettingThree districts of South India: Puducherry, Cuddalore and VillupuramSubjectsNewly diagnosed sputum smear positive pulmonary TB patients aged ≥16 yearsResultsIn total, 1188 TB patients were included. Prevalence of DM among TB patients was 39% (95% CI: 36.2% to 41.8%). In unadjusted analysis, elderly TB, marital status, caste, gender, higher education level, household income and obesity had a significant association with DM. However, in adjusted analysis, only marital status (currently married aPR; 3.77 (95 CI: 2.20 to 6.49), widowed/separated/divorced aPR; 3.66 (95 CI: 1.96 to 6.83)) and body mass index category (normal weight aPR; 3.26 (95 CI: 2.55 to 4.16), overweight aPR; 3.86 (95 CI: 2.69 to 5.52), obesity aPR; 4.08 (95 CI: 2.81 to 5.94)) were found to be significant determinants. The number of TB patients needed to be screened to find a new DM case was 12.ConclusionWe found that one in three TB patients had coexisting DM. The number of TB patients needed to be screened to obtain a newly diagnosed DM patients was also determined. The study supports and highlights the need of RNTCP’s effort in bidirectional screening of TB and DM.

scholarly journals Predictors of Health Care Seeking Pace Among Newly-Diagnosed Pulmonary Tuberculosis Patients In Cebu City, Philippines: A Cross-Sectional Study

2019 ◽  
Author(s):  
MARK JOHNUEL MATABILAS DUAVIS1
Keyword(s):  
Social Support ◽  
Health Care ◽  
Marital Status ◽  
Perceived Social Support ◽  
Social Stigma ◽  
Health Care Seeking ◽  
Care Seeking ◽  
Newly Diagnosed ◽  
Cross Sectional ◽  
Perceived Dangerousness

Abstract Background Tuberculosis remains a major public health dilemma in the Philippines. While free and effective TB diagnosis and treatment have been made available since 1996, a number of patients still delay accessing them re­sulting to increased TB mortality and community transmission. This study is aimed at determining the significant variables that can predict a TB patient’s pace in seeking appropriate health care. Methods A descriptive, correlational cross-sectional survey was done to 127 newly-diagnosed TB patients from 10 government-owned TB DOTS facilities in Cebu City. Participants were categorically grouped into Prompt Health Seekers and Delayed Health Seekers using a norm-referenced median dichotomy. Descriptive and inferential analysis utilized included Chi-square Test, Pearson’s Correlation and Discriminant Analysis. Results A mean health care seeking delay of 59 days (median=49) was recorded. Most of the participants experienced unexplained cough which they perceived as only slightly dangerous. 38% of them reported not knowing any symptom related to TB while 39% were not aware of the free public TB services. Most patients have made 2-3 prior health recourses, mostly through self-medication, before finally contacting a DOTS facility. Marital status (p=0.004), the number of symptoms experienced (p=0.000), first symptom experienced (p=0.016), perceived dangerousness of all symptoms experienced (p=0.009), perceived dangerousness of the first symptom experienced (p=0.001), perceived social stigma (p=0.035) and, perceived social support (p=0.002) were found to be significantly associated with the patients’ health care seeking pace. Extending to multivariate analysis, five independent variables namely marital status (p=0.037), number of symptoms experienced (p=0.018), perceived dangerousness of all the symptoms experienced (p=0.028), perceived social stigma (p=0.026) and, perceived social support (p=0.001) can significantly predict the patients’ health care seeking pace. Conclusion A considerable health care seeking delay of 59 days was documented, especially among those with lower perception of social support, higher perception of social stigma and those who do not currently have partners. Patients who experienced more symptoms and those who view these symptoms as less dangerous were, however, likely to seek immediate health care. Reducing health care seeking delays through intensified health information campaigns, strengthening social support systems and reducing social stigma is recommended.

scholarly journals Molecular Epidemiology of Pulmonary Tuberculosis in Southern Ethiopia

2020 ◽  
Author(s):  
Yared Merid ◽  
Elena Hailu ◽  
Getnet Habtamu ◽  
Melaku Tilahun ◽  
Markos Abebe ◽  
...  
Keyword(s):  
Rural Areas ◽  
Drug Susceptibility ◽  
Cross Sectional Study ◽  
Drug Susceptibility Testing ◽  
Southern Ethiopia ◽  
Sputum Smear ◽  
Smear Microscopy ◽  
Drug Resistant ◽  
Newly Diagnosed ◽  
Cross Sectional

Abstract Background Understanding the epidemiology of tuberculosis (TB) is limited by lack of genotyping data. We sought to characterize the drug susceptibility testing (DST) patterns and genetic diversity of M. tuberculosis (Mtb) isolates in Southern Ethiopia. Methodology A cross-sectional study was conducted among newly diagnosed sputum smear positive patients with TB visiting nine health facilities in southern Ethiopia from June 2015 to May 2016. Three consecutive sputum samples (spot-morning-spot) per patient were examined using acid-fast bacilli (AFB) smear microscopy with all smear positive specimens having AFB cultures performed. Mtb isolates had DST performed using indirect proportion method and were genotyped with RD9 deletion typing and spoligotyping. Spoligotyping International Types (SIT) and sub-lineages (clades) were assigned according to the SITVITWEB data base. Results Among 250 newly diagnosed patients with TB, 154 (52%) were male and 143 (57%) from rural areas. The prevalence of HIV co-infection was 4%. Of the 250 AFB positive sputum samples, 230 (92%) were culture positive. All 230 isolates were M. tuberculosis strains belonging to three lineages: Euro-American, 187 (81%); East-African-Indian, 31 (14%); and Lineage 7 (Ethiopian lineage), 8 (4%). The 230 isolates could be categorized into 65 different spoligotype patterns, of which 84% fell into 29 clusters. The dominant spoligotypes were SIT149 (21%), SIT53 (19%) and new strains (16%). Mtb strains were clustered by districts. DST revealed that 14% of Mtb isolates were resistant to > 1 first line anti-TB drugs including 11% to isoniazid. SIT 149 was the most prevalent genotype among drug resistant isolates (20%). Conclusion The study revealed several clusters including lineage 7 strains circulating in southern Ethiopia. SIT 149 (T3-ETH) was the most dominant circulating strain in the study area including among drug-resistant cases.

scholarly journals Tuberculosis prevalence and associated factors among persons with diabetes mellitus after intensified case finding in three West African countries

2021 ◽  
Vol 16 ◽  
Author(s):  
Ablo Prudence Wachinou ◽  
Serge Ade ◽  
Maimouna Ndour Mbaye ◽  
Boubacar Bah ◽  
Naby Balde ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Associated Factors ◽  
Close Contact ◽  
Case Finding ◽  
Sputum Smear ◽  
African Countries ◽  
Consultation Process ◽  
Cross Sectional ◽  
Factors Associated ◽  
Intensified Case Finding

Background: To determine the prevalence of tuberculosis (TB) and associated factors in persons with diabetes mellitus (DM) in Benin, Guinea and Senegal.Methods: A cross-sectional study was conducted in the largest DM center in each country. Participants systematically underwent clinical screening and chest radiography. Participants who were symptomatic or with abnormal radiography underwent bacteriological investigations (sputum smear, Xpert MTB/RIF and culture) on sputum. Participants with no TB at enrolment were re-examined for TB six months later. Logistic regression was performed to identify factors associated with TB.Results: There were 5870 DM patients: 1881 (32.0%) in Benin, 1912 (32.6%) in Guinea and 2077 (35.4%) in Senegal. Of these, 114 had bacteriologically-confirmed TB, giving a pooled prevalence of 1.9% (95%CI=1.6-2.3). TB prevalence was 0.5% (95%CI=0.3-1.0), 2.4% (95%CI=1.8-3.2) and 2.8% (95%CI=2.2-3.6), respectively, in Benin, Guinea and Senegal. Factors associated with an increased odds of TB diagnosis were a usual residence in Guinea (aOR=2.62;95%CI=1.19-5.77; p=0.016) or in Senegal (aOR=3.73;95%CI=1.85-7.51; p<0.001), the age group of 35-49 years (aOR=2.30;95%CI=1.11-4.79; p=0.025), underweight (aOR=7.34;95%CI=4.65-11.57; p<0.001) and close contact with a TB case (aOR=2.27;95%CI=1.37-3.76; p=0.002). Obesity was associated with lower odds of TB (aOR=0.20; 95%CI=0.06-0.65; p=0.008).Conclusion: TB is prevalent among DM patients in Benin, Guinea and Senegal and higher than among the general population. The findings support the need for intensified case finding in DM patients in order to ensure systematic early detection of TB during the routine consultation process.

scholarly journals The correlation between lipoprotein associated phospholipase A2 and central overweight status

2021 ◽  
Vol 35 ◽  
pp. 205873842110485
Author(s):  
Yi-Hsuan Chen ◽  
Wen-Cheng Li ◽  
Yi-Chuan Chen ◽  
Wei-Chung Yeh ◽  
Wei Yu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cardiovascular Disease ◽  
Cross Sectional Study ◽  
Normal Weight ◽  
Sectional Study ◽  
Chinese Adults ◽  
Cross Sectional ◽  
Overweight Status ◽  
Increased Risk ◽  
Objective Being

Objective: Being overweight is associated with an increased risk of diabetes mellitus, hypertension, and cardiovascular disease. Lipoprotein-associated phospholipase A2 (Lp-PLA2) can independently predict the risk of cardiovascular disease. This study is aimed to investigate whether Lp-PLA2 was associated with an overweight status. Methods: This was a cross-sectional study that enrolled 3760 Chinese adults (age, 18–50 years) who underwent medical examination department of Xiamen Chang-Gung Hospital (XCGH) from 2018 to 2020. To explore the distribution of overweight classifications in the Chinese population, we evaluated the correlation of the overweight status with Lp-PLA2, after correcting for possible influencing factors. Results: The Lp-PLA2 level was greater in male than in female subjects ( p < 0.001). Subjects with a central overweight status had a greater Lp-PLA2 level than those with normal weight and a peripheral overweight status, in both male and female cohorts. The Lp-PLA2 level was significantly greater in those with additional comorbidities (namely diabetes mellitus (DM), hypertension (HTN), overweight, and metabolic syndrome (MetS)). The age-adjusted and LDL-adjusted Lp-PLA2 level also was significantly higher in the DM (+) and HTN (−) subgroups than in the DM (−), HTN (−), DM (−), and HTN (+) subgroups. Conclusion: Lp-PLA2 is associated with sex, central overweight status, diabetes, hypertension, and MetS in adults aged < 50 years and the age-adjusted and LDL-adjusted Lp-PLA2 was significantly higher in the DM (+) and HTN (−) subgroups than in the DM (−) and HTN (−) and DM (−) and HTN (+) subgroups.

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