Treatment Outcome of Tuberculosis in Patients with Diabetes under RNTCP in a Tertiary Care Centre, Chengalpattu, India: A Prospective Cohort Study

Abstract

Introduction: Diabetes increases the risk of Tuberculosis (TB) by three times, and this bidirectional association is currently one of the major concerns. A stronger evidence base is required to clarify the impact of Diabetes Mellitus (DM) on the treatment outcome of TB. Aim: To compare the treatment outcome among diabetic and non diabetic patients on Category-I TB treatment based on the Revised National Tuberculosis Control Program (RNTCP). Also, to assess the various factors influencing the treatment outcome of TB among diabetic patients. Material and Methods: A prospective cohort study was conducted on 75 newly diagnosed TB patients enrolled for Category-I treatment Department of Pulmonary Medicine, Chengalpattu Medical College, Chengalpattu, Tamil Nadu, India, between October 2018 to November 2019. All patients with TB underwent blood glucose screening at treatment initiation and were categorised into two groups: with diabetes and without diabetes. Demographic details, family history of DM, smoking, alcohol consumption, and clinical profile were collected using a semi-structured questionnaire and followed-up for six months to assess their treatment outcome. The treatment outcome was compared statistically based on diabetes status using the Chi-square test. Results: The mean age of the study population was 49.9±0.5 years, with the majority being male 56 (74.7%). More than half of the study population belonged to a low socio-economic status. Among the study population, 42 (56%) were diabetic, with a mean blood glucose level of 242.7±80.5 mg/dL. Eighty-two percent had Pulmonary TB, with a 68% smear positivity rate among diabetic patients. In terms of treatment outcome, 44 (58.7%) were cured, 15 (20%) completed treatment, 10 (13.3%) were lost to followup, and 6 (8%) expired during the treatment course. Conclusion: Smear positivity and pulmonary TB were predominant among patients with diabetes. Treatment completion was lower, and mortality was higher among diabetic patients with TB.

Keywords

• blood glucose
• diabetes mellitus
• mycobacterium tuberculosis
• revised national tuberculosis control program