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Free Content Diabetes increases the risk of recent-transmission tuberculosis in household contacts in São Paulo, Brazil

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SETTING: A cohort of household contacts of tuberculosis (TB) index cases from four public health clinics in São Paulo, Brazil.

OBJECTIVE: To measure the association between diabetes mellitus (DM) among household contacts and recent-transmission TB (RT TB).

DESIGN: Index TB cases (n = 263) identified from 2001 to 2002 in São Paulo, whose household contacts (n = 1383) were monitored for active TB until December 2010.

RESULTS: From 2001 to 2010, there were 29 cases of RT TB among household contacts (cumulative incidence 2.1%, 95%CI 1.4–2.9). DM in household contacts was associated with RT TB (OR 3.96, 95%CI 1.33–11.79) even after adjustment for human immunodeficiency virus (HIV) status, smoking and alcohol use (adjusted OR [aOR] 3.21, 95%CI 1.01–10.19). HIV infection was also associated with RT TB (OR 6.40, 95%CI 1.40–29.40; aOR 4.81, 95%CI 0.96–24.18). Household contact DM was not associated with non-RT TB (OR 1.27, 95%CI 0.30–5.40). The time to diagnosis of TB was shorter in household contacts with and without DM (P = 0.035) and in household contacts with and without HIV (P = 0.0002).

CONCLUSION: Household contact DM was associated with an increased risk of RT TB in a cohort in Brazil, lending support to the active screening of household contacts with DM for TB in Brazil.
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Keywords: Brazil; chronic; disease; infectious; metabolic

Document Type: Research Article

Affiliations: 1: Department of Medicine, University of California, San Francisco, USA; Zuckerberg San Francisco General Hospital, San Francisco, California, USA 2: Department of Public Health, Instituto Adolfo Lutz, São Paulo, São Paulo, Brazil 3: School of Public Health, University of São Paulo, São Paulo, São Paulo, Brazil 4: School of Public Health, University of California, Berkeley, Berkeley, California, USA

Publication date: 01 August 2017

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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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