Diabetes mellitus is strongly associated with tuberculosis in Indonesia
Abstract:SETTING: Diabetes mellitus is a known risk factor for tuberculosis (TB), but no studies have been reported from South-East Asia, which has a high burden of TB and a rapidly growing prevalence of diabetes.
OBJECTIVE: To examine if and to what extent diabetes is associated with an increased risk of TB in an urban setting in Indonesia.
DESIGN: Case-control study comparing the prevalence of diabetes mellitus (fasting blood glucose level >126 mg/dl) among newly diagnosed pulmonary TB patients and matched neighbourhood controls.
RESULTS: Patients and control subjects had a similar age (median 30 years) and sex distribution (52% male), but malnutrition was more common among TB patients (median body mass index 17.7 vs. 21.5 kg/m2). HIV infection was uncommon (1.5% of patients). Diabetes mellitus was present in 60 of 454 TB patients (13.2%) and 18 of 556 (3.2%) control subjects (OR 4.7; 95%CI 2.7–8.1). Adjustment for possible confounding factors did not reduce the risk estimates. Following anti-tuberculosis treatment, hyperglycaemia reverted in a minority (3.7%) of TB patients.
CONCLUSION: Diabetes mellitus is strongly associated with TB in young and non-obese subjects in an urban setting in Indonesia. This may have implications for TB control and patient care in this region.
Document Type: Regular Paper
Affiliations: 1: Department of Internal Medicine, Medical Faculty, Padjadjaran University, Bandung, Indonesia 2: Department of Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands 3: Eijkman Institute of Molecular Biology, Jakarta, Indonesia 4: Department of Endocrinology, Epidemiology and Biostatistics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands 5: Indonesian Tuberculosis Control Association, Jakarta Branch, Jakarta, Indonesia 6: Department of Immunohematology and Bloodbank, Leiden University Medical Center, Leiden, The Netherlands 7: Infectious Disease Working Group, Medical Faculty, University of Indonesia, Jakarta, Indonesia
Publication date: June 1, 2006
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