The Diabetes-Tuberculosis Co-Epidemic: The Interaction between Individual and Socio-Economic Risk Factors

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Abstract

Worldwide, tuberculosis (TB) is a major cause of morbi-mortality, about 30% of the population having a Mycobacterium tuberculosis infection. Patients with diabetes mellitus (DM) have a threefold increased risk of developing the disease. The prevalence of DM is rapidly increasing, especially in countries with low and middle income, where TB incidence is also increased, thus baffling the efforts for TB control. The DM-TB co-epidemic is more frequent in married, older men, with reduced level of education, low income, without a steady job, with lifestyle habits such as alcohol consumption, smoking, sedentarism, living in an urban environment, in crowded areas, in insanitary conditions. These patients have a higher body mass index (BMI) compared with those without DM and frequently present family history of TB, family history of DM, longer duration of DM and reduced glycemic control. TB associated with DM is usually asymptomatic, more contagious, multidrug resistant and is significantly associated with an increased risk of therapy failure, relapse and even death. Thus, the DM-TB comorbidity represents a threat to public health and requires the implementation of urgent measures in order to both prevent and manage the two diseases.

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  • 1. International Diabetes Federation. IDF Diabetes Atlas – 7th Edition. Brussels Belgium: International Diabetes Federation 2015. Accesed on 24th January 2017 at: http://www.diabetesatlas.org/resources/2015-atlas.html.

  • 2. World Health Organization. Global tuberculosis report 2016. Geneva Switzerland: World Health Organization 2016. Accessed on 24th January 2017 at http://www.who.int/tb/publications/global_report/en/.

  • 3. Pal R Ansari MA Hameed S Fatima Z. Diabetes mellitus as hub for tuberculosis infection: a snapshot. Int J Chronic Dis 2016: 5981574 doi: 10.1155/2016/5981574 2016.

  • 4. Jeon CY Murray MB. Diabetes mellitus increases the risk of active tuberculosis: a systematic review of 13 observational studies. PLoS Med 5: e152 2008.

  • 5. Dooley KE Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis 9: 737-746 2009.

  • 6. Ruslami R Aarnoutse RE Alisjahbana B van der Ven AJ van Crevel R. Implications of the global increase of diabetes for tuberculosis control and patient care. Trop Med Int Health 15: 1289-1299 2010.

  • 7. Kapur A Harries AD. The double burden of diabetes and tuberculosis - public health implications. Diabetes Res Clin Pract 101: 10-19 2013.

  • 8. Lönnroth K Roglic G Harries AD. Improving tuberculosis prevention and care through addressing the global diabetic epidemic: from evidence to policy and practice. Lancet Diabetes Endocrinol 2: 730-739 2014.

  • 9. Zheng C Hu M Gao F. Diabetes and pulmonary tuberculosis: a global overview with special focus on the situation in Asian countries with high TB-DM burden. Glob Health Action 10: 1-11 2017.

  • 10. Baker MA Harries AD Jeon CY et al. The impact of diabetes on tuberculosis treatment outcomes: a systematic review. BMC Med 9: 81 2011.

  • 11. Stevenson CR Forouhi NG Roglic G et al. Diabetes and tuberculosis: the impact of the diabetes epidemic on tuberculosis incidence. BMC Public Health 7: 234 2007.

  • 12. Raghuraman S Vasudevan KP Govindarajan S Chinnakali P Panigrahi KC. Prevalence of diabetes mellitus among tuberculosis patients in urban Puducherry. N Am J Med Sci 6: 30-34 2014.

  • 13. Aftab H Ambreen A Jamil M et al. High prevalence of diabetes and anthropometric heterogeneity among tuberculosis patients in Pakistan. Trop Med Int Health 2017. doi:10.1111/tmi.12842. [Epub ahead of print]

  • 14. Abdelbary BE Garcia-Viveros M Ramirez-Oropesa H Rahbar MH Restrepo BI. Tuberculosis-diabetes epidemiology in the border and non-border regions of Tamaulipas Mexico. Tuberculosis 101: S124-S134 2016.

  • 15. Gil-Santana L Almeida-Junior JL Oliveira CA et al. Diabetes is associated with worse clinical presentation in tuberculosis patients from Brazil: A retrospective cohort study. PLoS One 11: e0146876 2016.

  • 16. Sarker M Barua M Guerra F et al. Double trouble: prevalence and factors associated with tuberculosis and diabetes comorbidity in Bangladesh. PLoS One 11: e0165396 2016.

  • 17. Delgado-Sánchez G García-García L Castellanos-Joya M et al. Association of pulmonary tuberculosis and diabetes in Mexico: Analysis of the national tuberculosis registry 2000–2012. PLoS One 10: e0129312 2015.

  • 18. Ogbera AO Kapur A Abdur-Razzaq H et al. Clinical profile of diabetes mellitus in tuberculosis. BMJ Open Diabetes Res Care 3: e000112 2015.

  • 19. Wang Q Ma A Han X et al. Prevalence of type 2 diabetes among newly detected pulmonary tuberculosis patients in China: A community based cohort study. PLoS One 8: e82660 2013.

  • 20. Viswanathan V Kumpatla S Aravindalochanan V et al. Prevalence of diabetes and pre-diabetes and associated risk factors among tuberculosis patients in India. PLoS One 7: e41367 2012.

  • 21. Goldhaber-Fiebert JD Jeon CY Cohen T Murray MB. Diabetes mellitus and tuberculosis in countries with high tuberculosis burdens: individual risks and social determinants. Int J Epidemiol 40: 417-428 2011.

  • 22. Restrepo BI Camerlin AJ Rahbar MH et al. Cross-sectional assessment reveals high diabetes prevalence among newly-diagnosed tuberculosis cases. Bull World Health Organ 89: 352-359 2011.

  • 23. Manjareeka M Palo SK Swain S Pati S Pati S. Diabetes mellitus among newly diagnosed tuberculosis patients in tribal Odisha: An exploratory study. J Clin Diagn Res 10: LC06-LC08 2016.

  • 24. Agarwal AK Ginisha G Preeti G Dwivedi S Swamai P. The association between diabetes and tuberculosis may be the next challenge for global tuberculosis control worldwide. Indian J Endocrinol Metab 20: 732-733 2016.

  • 25. Harries AD Kumar AM Satyanarayana S et al. Diabetes mellitus and tuberculosis: programmatic management issues. Int J Tuberc Lung Dis 19: 879-886 2015.

  • 26. Kumpatla S Sekar A Achanta S et al. Characteristics of patients with diabetes screened for tuberculosis in a tertiary care hospital in South India. Public Health Action 3 [Suppl 1]: S23-S28 2013.

  • 27. Faurholt-Jepsen D Range N PrayGod G et al. The role of anthropometric and other predictors for diabetes among urban Tanzanians with tuberculosis. Int J Tuberc Lung Dis 16: 1680-1685 2012.

  • 28. Restrepo BI Fisher-Hoch SP Crespo JG et al. Type 2 diabetes and tuberculosis in a dynamic bi-national border population. Epidemiol Infect 135: 483-491 2007.

  • 29. Alisjahbana B Sahiratmadja E Nelwan EJ et al. The effect of type 2 diabetes mellitus on the presentation and treatment response of pulmonary tuberculosis. Clin Infect Dis 45: 428-435 2007.

  • 30. Siddiqui AN Khayyam KU Sharma M. Effect of diabetes mellitus on tuberculosis treatment outcome and adverse reactions in patients receiving directly observed treatment strategy in India: A prospective study. Biomed Res Int 2016: 7273935 2016.

  • 31. Caraffa E Schepisi MS Gualano G et al. The diabetes-tuberculosis co-epidemic: the role of international migration. Int J Tuberc Lung Dis 20: 771–777 2016.

  • 32. Lin YH Chen CP Chen PY et al. Screening for pulmonary tuberculosis in type 2 diabetes elderly: a cross-sectional study in a community hospital. BMC Public Health 15: 3 2015.

  • 33. Kouismi H Hammi S Bouti K et al. Pulmonary tuberculosis and diabetes mellitus profile. Int J Med Surg 2: 11-15 2015.

  • 34. Baghaei P Marjani M Javanmard P Tabarsi P Masjedi MR. Diabetes mellitus and tuberculosis facts and controversies. J Diabetes Metab Disord 12: 58 2013.

  • 35. Balakrishnan S Vijayan S Nair S et al. High diabetes prevalence among tuberculosis cases in Kerala India. PLoS One 7: e46502 2012.

  • 36. Achanta S Tekumalla RR Jaju J et al. Screening tuberculosis patients for diabetes in a tribal area in South India. Public Health Action 3: S43-S47 2013.

  • 37. Pizzol D Di Gennaro F Chhaganlal KD et al. Tuberculosis and diabetes: current state and future perspectives. Trop Med Int Health 21: 694-702 2016.

  • 38. Fekadu S Yigzaw M Alemu S et al. Insulin-requiring diabetes in Ethiopia: associations with poverty early undernutrition and anthropometric disproportion. Eur J Clin Nutr 64: 1192-1198 2010.

  • 39. Ponce-De-Leon A Garcia-Garcia Md Mde L Garcia-Sancho MC et al. Tuberculosis and diabetes in southern Mexico. Diabetes Care 27: 1584-1590 2004.

  • 40. Carreira S Costeira J Gomes C André JM Diogo N. Impact of diabetes on the presenting features of tuberculosis in hospitalized patients. Rev Port Pneumol 18: 239-243 2012.

  • 41. Lönnroth K Williams BG Cegielski P Dye C. A consistent log-linear relationship between tuberculosis incidence and body mass index. Int J Epidemiol 39: 149-155 2010.

  • 42. Skowroński M Zozulińska-Ziółkiewicz D Barinow-Wojewódzki A. Tuberculosis and diabetes mellitus – an underappreciated association. Arch Med Sci 10: 1019-1027 2014.

  • 43. Amare H Gelaw A Anagaw B Gelaw B. Smear positive pulmonary tuberculosis among diabetic patients at the Dessie referral hospital Northeast Ethiopia. Infect Dis Poverty 2: 6 2013.

  • 44. Rajavashisth TB Shaheen M Norris KC et al. Decreased prevalence of diabetes in marijuana users: cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) III. BMJ Open 2: e000494 2012.

  • 45. Girardi E Schepisi MS Goletti D et al. The global dynamics of diabetes and tuberculosis: the impact of migration and policy implications. Int J Infect Dis 2017. doi: 10.1016/j.ijid.2017.01.018. [Epub ahead of print]

  • 46. Renzaho AM. The post-2015 development agenda for diabetes in sub-Saharan Africa: challenges and future directions. Glob Health Action 8: 27600 2015.

  • 47. Wang Q Ma A Bygbjerg IC et al. Rationale and design of a randomized controlled trial of the effect of retinol and vitamin D supplementation on treatment in active pulmonary tuberculosis patients with diabetes. BMC Infect Dis 13: 104 2013.

  • 48. Baldé NM Camara A Camara LM Diallo MM Kaké A Bah-Sow OY. Associated tuberculosis and diabetes in Conakry Guinea: prevalence and clinical characteristics. Int J Tuberc Lung Dis 10: 1036-1040 2006.

  • 49. Dobler CC Flack JR Marks GB. Risk of tuberculosis among people with diabetes mellitus: an Australian nationwide cohort study. BMJ Open 2: e000666 2012.

  • 50. Lönnroth K Jaramillo E Williams BG Dye C Raviglione M. Drivers of tuberculosis epidemics: the role of risk factors and social determinants. Soc Sci Med 68: 2240-2246 2009.

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