A study from Taiwan involving Pulmonary Tuberculosis entitled “Screening for pulmonary tuberculosis in type 2 diabetes elderly: a cross-sectional study in a community hospital” was recently published in the journal BMC Public Health.
Pulmonary Tuberculosis (TB) and Diabetes Mellitus (DM) are both the major global health problems. The World Health Organization (WHO) estimations are 8.7 million incident cases of TB and 1.4 million deaths from TB in 2011. The International Diabetes Federation (IDF) notes that nearly 371 million people all over the world have TB.
Risk factors associated with TB are widely recognized. These include male gender, cigarette smoking, alcohol consumption, underweight, renal disease, household contact, socioeconomic status, and diabetes mellitus. As the number of diabetes patients continue to increase year by year, more and more studies are focused on TB prevention in this patient population. Evidence shows that the risk of TB increases with diabetes.
In this regard, Yung-Hsiang Lin from the Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital in Taiwan, screened a total of 3,087 patients with Type 2 diabetes aged over 65 years in order to identify the prevalence of tuberculosis and its determinants in this elderly population. All the participants were examined for pulmonary tuberculosis with x-rays, blood tests and questionnaires to assess medical history and symptoms. The team of researchers found 7 patients positive for active pulmonary tuberculosis through analysis of sputum culture.
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Using univariate analysis, results revealed in 73 patients with active pulmonary tuberculosis a prevalence rate of 3.89 cases of comorbid tuberculosis per thousand cases of Type 2 diabetes in people aged over 65 years.
In terms of risk factors, all the patients that tested positive for active pulmonary tuberculosis were male, with smoking history, liver cirrhosis, more alcohol consumption, more history of tuberculosis, higher low density lipoprotein, and less hypertension. Subjective body weight loss was associated with the risk of pulmonary tuberculosis. Results also revealed no differences between the tuberculosis and non-tuberculosis groups in terms of glycated hemoglobin.
Yung-Hsiang Lin and colleagues concluded that screening programs to detect pulmonary tubercolisis are necessary to in patients with diabetes aged over 65 years. Moreover, in terms of risk factors, the finding revealed that body weight loss, smoking and liver cirrhosis are independent factors in the population.