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Free Content Diabetes mellitus is strongly associated with tuberculosis in Indonesia

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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.
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Keywords: Indonesia; case-control study; diabetes mellitus type 2; pulmonary; relative odds; tuberculosis

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: 2006-06-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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