TY - JOUR
T1 - Diabetes mellitus and tuberculosis treatment outcomes in Pune, India
AU - Mave, Vidya
AU - Gaikwad, Sanjay
AU - Barthwal, Madhusudan
AU - Chandanwale, Ajay
AU - Lokhande, Rahul
AU - Kadam, Dileep
AU - Dharmshale, Sujata
AU - Bharadwaj, Renu
AU - Kagal, Anju
AU - Pradhan, Neeta
AU - Deshmukh, Sona
AU - Atre, Sachin
AU - Sahasrabudhe, Tushar
AU - Meshram, Shailesh
AU - Kakrani, Arjun
AU - Kulkarni, Vandana
AU - Raskar, Swapnil
AU - Suryavanshi, Nishi
AU - Kornfeld, Hardy
AU - Dooley, Kelly E.
AU - Chon, Sandy
AU - Gupte, Akshay
AU - Gupta, Amita
AU - Gupte, Nikhil
AU - Golub, Jonathan E.
N1 - Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of Infectious Diseases Society of America.
PY - 2021/4/1
Y1 - 2021/4/1
N2 - Background: Diabetes mellitus (DM) increases the risk of tuberculosis (TB) disease. Knowledge of the impact of DM on TB treatment outcomes is primarily based on retrospective studies. Methods: We conducted a prospective cohort study of new pulmonary TB patients with and without DM (TB-DM and TB only) in India. The association of DM with a composite unfavorable TB treatment outcome (failure, recurrence, mortality) over 18 months was determined, and the effect of DM on all-cause mortality and early mortality (death during TB treatment) was assessed. Results: Of 799 participants, 574 (72%) had TB only and 225 (28%) had TB-DM. The proportion of patients with DM who experienced the composite outcome was 20%, as compared with 21% for TB-only participants (adjusted hazard ratio [aHR], 1.13; 95% CI, 0.75-1.70). Mortality was higher in participants with DM (10% vs 7%), and early mortality was substantially higher among patients with DM (aHR, 4.36; 95% CI, 1.62-11.76). Conclusions: DM was associated with early mortality in this prospective cohort study, but overall unfavorable outcomes were similar to participants without DM. Interventions to reduce mortality during TB treatment among people with TB-DM are needed.
AB - Background: Diabetes mellitus (DM) increases the risk of tuberculosis (TB) disease. Knowledge of the impact of DM on TB treatment outcomes is primarily based on retrospective studies. Methods: We conducted a prospective cohort study of new pulmonary TB patients with and without DM (TB-DM and TB only) in India. The association of DM with a composite unfavorable TB treatment outcome (failure, recurrence, mortality) over 18 months was determined, and the effect of DM on all-cause mortality and early mortality (death during TB treatment) was assessed. Results: Of 799 participants, 574 (72%) had TB only and 225 (28%) had TB-DM. The proportion of patients with DM who experienced the composite outcome was 20%, as compared with 21% for TB-only participants (adjusted hazard ratio [aHR], 1.13; 95% CI, 0.75-1.70). Mortality was higher in participants with DM (10% vs 7%), and early mortality was substantially higher among patients with DM (aHR, 4.36; 95% CI, 1.62-11.76). Conclusions: DM was associated with early mortality in this prospective cohort study, but overall unfavorable outcomes were similar to participants without DM. Interventions to reduce mortality during TB treatment among people with TB-DM are needed.
KW - India
KW - diabetes mellitus
KW - mortality
KW - tuberculosis
KW - unfavorable treatment outcomes
UR - http://www.scopus.com/inward/record.url?scp=85106445043&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85106445043&partnerID=8YFLogxK
U2 - 10.1093/ofid/ofab097
DO - 10.1093/ofid/ofab097
M3 - Article
C2 - 33884278
AN - SCOPUS:85106445043
SN - 2328-8957
VL - 8
JO - Open Forum Infectious Diseases
JF - Open Forum Infectious Diseases
IS - 4
M1 - ofab097
ER -