Skip to main content

Free Content High prevalence of Mycobacterium tuberculosis infection and disease in children and adolescents with type 1 diabetes mellitus

Download Article:
 Download
(PDF 278.67578125 kb)
 

Abstract:

SETTING: Western Cape Province, South Africa.

OBJECTIVES: To describe the prevalence of tuberculosis (TB) infection and disease in children with type 1 diabetes and to investigate the association between glycaemic control and prevalence of TB infection and disease.

DESIGN: Cross-sectional hospital-based study conducted at two public referral hospitals. All children and adolescents (aged <21 years) with type 1 diabetes underwent a Mantoux tuberculin skin test (≥10 mm classified as Mycobacterium tuberculosis infection), measurement of glycosylated haemoglobin and a chest radiograph. Patients with symptoms suggestive of TB were investigated using mycobacterial culture. Radiologically and/or bacteriologically confirmed disease was classified as TB disease.

RESULTS: Of 291 eligible patients, 258 (88.7%) were included (58% female). The prevalence of M. tuberculosis infection was 29.8% (95%CI 24.2–35.4); nine patients were diagnosed with prevalent TB disease (point prevalence disease 3488 per 100 000 population). Poor glycaemic control (hazard ratio 1.39, 95%CI 1.18–1.63 per unit increase in glycated haemoglobin [HbA1c]) and contact with a TB source case (P = 0.0011) was associated with prevalent TB disease.

CONCLUSIONS: There is a high prevalence of TB disease in diabetic children and adolescents in this setting. Routine TB screening of children with type 1 diabetes may be indicated in settings highly endemic for TB. Preventive treatment should be considered for diabetic children with proof of TB exposure and/or infection.

Keywords: childhood; diabetes; glycaemic control; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Department of Paediatrics and Child Health, Desmond Tutu TB Centre, Stellenbosch University and Tygerberg Children's Hospital, Cape Town, South Africa 2: Biostatistics Unit, Medical Research Council, Tygerberg, South Africa 3: Department of Paediatric and Adolescent Endocrinology, Groote Schuur and Red Cross Children's Hospitals, University of Cape Town, Cape Town, South Africa 4: Department of Paediatric and Adolescent Endocrinology, Great Ormond Street Children's Hospital, London, United Kingdom

Publication date: 2009-07-01

More about this publication?
  • 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

  • Editorial Board
  • Information for Authors
  • Subscribe to this Title
  • International Journal of Tuberculosis and Lung Disease
  • Public Health Action
  • Ingenta Connect is not responsible for the content or availability of external websites
  • Access Key
  • Free content
  • Partial Free content
  • New content
  • Open access content
  • Partial Open access content
  • Subscribed content
  • Partial Subscribed content
  • Free trial content
Cookie Policy
X
Cookie Policy
Ingenta Connect website makes use of cookies so as to keep track of data that you have filled in. I am Happy with this Find out more