Pulmonary Tuberculosis Screening in Patients with Diabetes Mellitus

Open access


Background and aims: Diabetes mellitus (DM) is a risk factor for pulmonary tuberculosis (TB), increasing the risk of progression of latent tuberculosis infection (LTBI) to active TB threefold, threatening the TB control, especially in developing countries. The aim of this study was to assess active and latent TB infection frequency in patients with DM.

Material and methods: There were enrolled in this study 503 adult DM patients. Active TB screening was performed through anamnestic data, clinical examination and chest X-ray and latent TB infection screening was evaluated using the tuberculin skin tests (TST).

Results: A number of 63 (12.5%) patients had type 1 DM and 440 (87.5%) had type 2 DM. Personal history of TB was present in 21 (4.2%) subjects, 5 (8.1%) with type 1 DM and 16 (3.6%) with type 2 DM. The TST was positive in 258 (51.5%) patients and 54 (10.7%) presented cough for more than two weeks at the time of examination. The chest X-ray revealed suggestive lesions for active TB in 4 (1%) subjects and lesions of inactive TB in 90 (22.4%) subjects.

Conclusions: TB screening must receive proper attention in patients with DM, being essential for diagnosis in those with nonspecific symptoms.

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  • 1. International Diabetes Federation. IDF Diabetes Atlas - 8th Edition. Brussels Belgium: International Diabetes Federation. 2017. Accessed on 9th March 2019 at http://www.diabetesatlas.org.

  • 2. Mota M Popa SG Mota E et al. Prevalence of diabetes mellitus and prediabetes in the adult Romanian population: PREDATORR study. J Diabetes 8(3): 336-344 2016.

  • 3. World Health Organization. Global tuberculosis report 2018. Geneva Switzerland: World Health Organization. 2018. Accessed on 9th March 2019 at https://www.who.int/tb/publications/global_report/en/.

  • 4. Restrepo BI. Diabetes and Tuberculosis. Microbiol Spectr 4(6) 2016.

  • 5. Riza AL Pearson F Ugarte-Gil C et al. Clinical management of concurrent diabetes and tuberculosis and the implications for patient services. Lancet Diabetes Endocrinol 2(9): 740-753 2014.

  • 6. Hoa NB Phuc PD Hien NT et al. Prevalence and associated factors of diabetes mellitus among tuberculosis patients in Hanoi Vietnam. BMC Infect Dis 18(1): 603 2018.

  • 7. Workneh MH Bjune GA Yimer SA. Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review. PLoS One 12: 0175925 2017.

  • 8. 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): 1-11 2017.

  • 9. Pizzol D Di Gennaro F Chhaganlal KD et al. Tuberculosis and diabetes: current state and future perspectives. Trop Med Int Health 21(6): 694-702 2016.

  • 10. 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 56: 45-53 2017.

  • 11. 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.

  • 12. 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(11): 1289-1299 2010.

  • 13. 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(1): 6 2013.

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

  • 15. Leung CC Lam TH Chan WM et al. Diabetic control and risk of tuberculosis: a cohort study. Am J Epidemiol 167(12): 1486-1494 2008.

  • 16. Hensel RL Kempker RR Tapia J Oladele A Blumberg HM Magee MJ. Increased risk of latent tuberculous infection among persons with pre-diabetes and diabetes mellitus. Int J Tuberc Lung Dis 20: 71-78 2016.

  • 17. World Health Organization. Global tuberculosis report 2016. Geneva Switzerland: World Health Organization. 2016. Accessed on 3rd May 2019 at https://apps.who.int/medicinedocs/en/d/Js23098en/.

  • 18. Young F Wotton CJ Critchley JA Unwin NC Goldacre MJ. Increased risk of tuberculosis disease in people with diabetes mellitus: record-linkage study in a UK population. J Epidemiol Community Health 66(6): 519-523 2012.

  • 19. Warwick MT. Pulmonary tuberculosis and diabetes mellitus. Q J Med 26: 31-42 1957.

  • 20. Silwer H Oscarsson PN. Incidence and coincidence of diabetes mellitus and pulmonary tuberculosis in a Swedish county. Acta Med Scand Suppl 335: 1-48 1958.

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