• Bmc Infect Dis · Jun 2017

    Tuberculosis screening among persons with diabetes mellitus in Pune, India.

    • Vidya Mave, Smita Nimkar, Haridas Prasad, Dileep Kadam, Sushant Meshram, Rahul Lokhande, Nikhil Gupte, Divyashri Jain, Amita Gupta, and Jonathan E Golub.
    • Byramjee-Jeejeebhoy Government Medical College-Johns Hopkins University Clinical Research Site, 1st Floor, Pathology Museum, Jai Prakash Narayan Road, Pune, Maharashtra, 411001, India. vidyamave@gmail.com.
    • Bmc Infect Dis. 2017 Jun 2; 17 (1): 388.

    BackgroundDiabetes mellitus (DM) increases tuberculosis (TB) risk, and there is increasing concern over the public health implications of the convergence of these two epidemics. Screening for TB among people with DM is now recommended in India.MethodsPeople with DM seeking care at a large public sector tertiary care hospital clinic in Pune, India, were screened for TB from June 2015 to May 2016. All consenting people with DM were screened for TB at each clinic visit using a five-item, WHO-recommended questionnaire and those with TB symptoms and/or risk factors were tested for active TB using sputum smear microscopty, Xpert® MTB/RIF and TB culture. Categorical data and continuous variables were summarized using descriptive statistics. The x 2 test or Wilcoxon rank-sum test was used to ascertain significant associations between categorical and continuous variables, respectively.ResultsAmong 630 adults approached for screening, median age was 60 (interquartile range (IQR), 57-64) years and 350 (56%) were females. Median hemoglobin A1c (HbA1c) was 8.7% (IQR, 6.7-9.9) and 444 (70.5%) were poorly controlled DM (HbA1c > 7). Forty-four (7%) had prior history of TB but the proportion with TB risk factors at screening was low (<5%). While 18% of participants reported any TB symptoms, none of these patients were diagnosed with culture confirmed TB.ConclusionsOur study failed to yield any active TB cases using a WHO-recommended questionnaire among people with DM. High TB risk populations among people with DM must be identified if TB screening is to be feasible in settings such as India where the DM epidemic continues to rise.

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