Socio-demographic and clinical differences in subjects with tuberculosis with and without diabetes mellitus in Brazil--a multivariate analysis.

<h4>Background</h4>Several studies have evaluated the relationship between diabetes mellitus (DM) and tuberculosis (TB), but the nature of this relationship is not fully understood. TB incidence may be influenced by immunosuppression from DM, but this association may be confounded by oth...

Full description

Saved in:
Bibliographic Details
Main Authors: Barbara Reis-Santos, Rodrigo Locatelli, Bernardo L Horta, Eduardo Faerstein, Mauro N Sanchez, Lee W Riley, Ethel Leonor Maciel
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0062604&type=printable
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850224891805040640
author Barbara Reis-Santos
Rodrigo Locatelli
Bernardo L Horta
Eduardo Faerstein
Mauro N Sanchez
Lee W Riley
Ethel Leonor Maciel
author_facet Barbara Reis-Santos
Rodrigo Locatelli
Bernardo L Horta
Eduardo Faerstein
Mauro N Sanchez
Lee W Riley
Ethel Leonor Maciel
author_sort Barbara Reis-Santos
collection DOAJ
description <h4>Background</h4>Several studies have evaluated the relationship between diabetes mellitus (DM) and tuberculosis (TB), but the nature of this relationship is not fully understood. TB incidence may be influenced by immunosuppression from DM, but this association may be confounded by other clinical and socioeconomic factors. We aimed to assess socio-demographic and clinical differences in TB patients with and without DM.<h4>Methods</h4>Using the Brazilian national surveillance system (SINAN), we compared 1,797 subjects with TB and DM with 29,275 subjects diagnosed with TB only in 2009. We performed multivariate analysis to identify factors associated with the presence of DM among TB patients.<h4>Results</h4>Subjects with TB - DM were older; have initial positive sputum smear test (OR = 1.42, 95% CI 1.26-1.60), and were more likely to die from TB (OR = 1.44, 95% CI 1.03-2.01). They were less likely to have been institutionalized [in prison, shelter, orphanage, psychiatric hospital (OR = 0.74, 95% CI 0.60-0.93)]; developed extra pulmonary TB (OR = 0.62, 95% CI 0.51-0.75) and to return to TB treatment after abandonment (OR = 0.66, 95% CI 0.51-0.86).<h4>Conclusions</h4>Prevalence of NCD continues to rise in developing countries, especially with the rise of elderly population, the prevention and treatment of infectious diseases will be urgent. DM and TB represent a critical intersection between communicable and non-communicable diseases in these countries and the effect of DM on TB incidence and outcomes provide numerous opportunities for collaboration and management of these complex diseases in the national public health programs.
format Article
id doaj-art-d6c8299a853d4f61ad0730bd7a8e6ab1
institution OA Journals
issn 1932-6203
language English
publishDate 2013-01-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj-art-d6c8299a853d4f61ad0730bd7a8e6ab12025-08-20T02:05:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0184e6260410.1371/journal.pone.0062604Socio-demographic and clinical differences in subjects with tuberculosis with and without diabetes mellitus in Brazil--a multivariate analysis.Barbara Reis-SantosRodrigo LocatelliBernardo L HortaEduardo FaersteinMauro N SanchezLee W RileyEthel Leonor Maciel<h4>Background</h4>Several studies have evaluated the relationship between diabetes mellitus (DM) and tuberculosis (TB), but the nature of this relationship is not fully understood. TB incidence may be influenced by immunosuppression from DM, but this association may be confounded by other clinical and socioeconomic factors. We aimed to assess socio-demographic and clinical differences in TB patients with and without DM.<h4>Methods</h4>Using the Brazilian national surveillance system (SINAN), we compared 1,797 subjects with TB and DM with 29,275 subjects diagnosed with TB only in 2009. We performed multivariate analysis to identify factors associated with the presence of DM among TB patients.<h4>Results</h4>Subjects with TB - DM were older; have initial positive sputum smear test (OR = 1.42, 95% CI 1.26-1.60), and were more likely to die from TB (OR = 1.44, 95% CI 1.03-2.01). They were less likely to have been institutionalized [in prison, shelter, orphanage, psychiatric hospital (OR = 0.74, 95% CI 0.60-0.93)]; developed extra pulmonary TB (OR = 0.62, 95% CI 0.51-0.75) and to return to TB treatment after abandonment (OR = 0.66, 95% CI 0.51-0.86).<h4>Conclusions</h4>Prevalence of NCD continues to rise in developing countries, especially with the rise of elderly population, the prevention and treatment of infectious diseases will be urgent. DM and TB represent a critical intersection between communicable and non-communicable diseases in these countries and the effect of DM on TB incidence and outcomes provide numerous opportunities for collaboration and management of these complex diseases in the national public health programs.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0062604&type=printable
spellingShingle Barbara Reis-Santos
Rodrigo Locatelli
Bernardo L Horta
Eduardo Faerstein
Mauro N Sanchez
Lee W Riley
Ethel Leonor Maciel
Socio-demographic and clinical differences in subjects with tuberculosis with and without diabetes mellitus in Brazil--a multivariate analysis.
PLoS ONE
title Socio-demographic and clinical differences in subjects with tuberculosis with and without diabetes mellitus in Brazil--a multivariate analysis.
title_full Socio-demographic and clinical differences in subjects with tuberculosis with and without diabetes mellitus in Brazil--a multivariate analysis.
title_fullStr Socio-demographic and clinical differences in subjects with tuberculosis with and without diabetes mellitus in Brazil--a multivariate analysis.
title_full_unstemmed Socio-demographic and clinical differences in subjects with tuberculosis with and without diabetes mellitus in Brazil--a multivariate analysis.
title_short Socio-demographic and clinical differences in subjects with tuberculosis with and without diabetes mellitus in Brazil--a multivariate analysis.
title_sort socio demographic and clinical differences in subjects with tuberculosis with and without diabetes mellitus in brazil a multivariate analysis
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0062604&type=printable
work_keys_str_mv AT barbarareissantos sociodemographicandclinicaldifferencesinsubjectswithtuberculosiswithandwithoutdiabetesmellitusinbrazilamultivariateanalysis
AT rodrigolocatelli sociodemographicandclinicaldifferencesinsubjectswithtuberculosiswithandwithoutdiabetesmellitusinbrazilamultivariateanalysis
AT bernardolhorta sociodemographicandclinicaldifferencesinsubjectswithtuberculosiswithandwithoutdiabetesmellitusinbrazilamultivariateanalysis
AT eduardofaerstein sociodemographicandclinicaldifferencesinsubjectswithtuberculosiswithandwithoutdiabetesmellitusinbrazilamultivariateanalysis
AT mauronsanchez sociodemographicandclinicaldifferencesinsubjectswithtuberculosiswithandwithoutdiabetesmellitusinbrazilamultivariateanalysis
AT leewriley sociodemographicandclinicaldifferencesinsubjectswithtuberculosiswithandwithoutdiabetesmellitusinbrazilamultivariateanalysis
AT ethelleonormaciel sociodemographicandclinicaldifferencesinsubjectswithtuberculosiswithandwithoutdiabetesmellitusinbrazilamultivariateanalysis