High Diabetes Prevalence among Tuberculosis Cases in Kerala, India
High Diabetes Prevalence among Tuberculosis Cases in Kerala, India
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DOI：
10.1371/journal.pone.0046502
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发表时间：
2012-10-15
期刊：
影响因子：
3.7
通讯作者：
Nair, Sreenivas Achuthan
中科院分区：
文献类型：
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作者：
Balakrishnan, Shibu;Vijayan, Shibu;Nair, Sreenivas Achuthan
背景：虽然糖尿病（DM）是结核病的一个已知危险因素，但印度结核病患者的患病率尚不清楚。对结核病患者进行糖尿病的常规筛查可能是早期诊断和改善管理的机会，并可能改善结核病治疗结果。我们进行了一项横断面调查的结核病患者登记，从2011年6月至7月在印度的喀拉拉邦，以确定DM的患病率。方法/主要发现：一个全州范围内的代表性样本的结核病患者在喀拉拉邦进行了采访和筛选DM使用糖化血红蛋白（HbA 1c）;患者自我报告的糖尿病史或HbA 1c ≥ 6.5%被定义为糖尿病。在接受筛查的552名结核病患者中，243人（44%）患有糖尿病，128人（23%）以前曾患有糖尿病，115人（21%）是新诊断的，男性和年龄> 50岁的人患病率较高。发现一个新诊断的糖尿病病例所需的筛查（NNS）数量仅为4个。128结核病患者与以前已知的DM，107（84%）HbA 1c>= 7%，表明血糖控制不佳Conclusions/Significance：近一半的结核病患者在喀拉拉邦有DM，这些患者中约有一半是新诊断的，在本次调查。使用HbA 1c对结核病患者进行糖尿病常规筛查产生了大量的糖尿病病例，并提供了早期管理机会，这可能会改善结核病和糖尿病的结局。然而，最具成本效益的方法，糖尿病筛查需要建立进一步的业务研究。
Background: While diabetes mellitus (DM) is a known risk factor for tuberculosis, the prevalence among TB patients in India is unknown. Routine screening of TB patients for DM may be an opportunity for its early diagnosis and improved management and might improve TB treatment outcomes. We conducted a cross-sectional survey of TB patients registered from June-July 2011 in the state of Kerala, India, to determine the prevalence of DM.Methodology/Principal Findings: A state-wide representative sample of TB patients in Kerala was interviewed and screened for DM using glycosylated hemoglobin (HbA1c); patients self-reporting a history of DM or those with HbA1c >= 6.5% were defined as diabetic. Among 552 TB patients screened, 243(44%) had DM - 128(23%) had previously known DM and 115(21%) were newly diagnosed - with higher prevalence among males and those aged >50years. The number needed to screen(NNS) to find one newly diagnosed case of DM was just four. Of 128 TB patients with previously known DM, 107(84%) had HbA1c >= 7% indicating poor glycemic control.Conclusions/Significance: Nearly half of TB patients in Kerala have DM, and approximately half of these patients were newly-diagnosed during this survey. Routine screening of TB patients for DM using HbA1c yielded a large number of DM cases and offered earlier management opportunities which may improve TB and DM outcomes. However, the most cost-effective ways of DM screening need to be established by futher operational research.