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Prevalence and clinical features of tuberculosis in Ethiopian diabetic patients
Y Feleke1, J Abdulkadir, G Aderaye
1Endocrinology and Metabolism Unit, Addis Ababa University, Ethiopia.
Objective:
To determine the prevalence and clinical characteristics of tuberculosis (TB) in diabetic patients.
Design:
This study was a cross-sectional survey based on the retrospective analysis of data on tuberculosis in diabetic patients.
Settings:
The study was conducted at Endocrinology and Metabolism Unit of the Department of Internal Medicine, Faculty of Medicine, Addis Ababa, Ethiopia.
Subjects:
Seventy-eight cases of tuberculosis among 1352 diabetic patients were included from September 1989 to 1996.
Main Outcome Measures:
Clinical evaluation, chest x-ray, acid fast bacilli (AFB) in sputum or measures tissue and histopathologic characteristic of biopsy specimens.
Results:
Seventy-eight cases of TB were identified among 1352 diabetic patients giving a prevalence of 5.8%. Among 1352 diabetic patients, 713 (52.7%) were males, 639 (43.3%) were females, 619 (45.8%) were IDDM and 733 (54.2%) were NIDDM. The mean age of the 71 TB patients whose records could be retrieved was 34.0 +/- 11.9 years, 42(59%) were males, 29 (41%) were females. Fifty-four (76.1%) were IDDM and 17(23.9%) were NIDDM, 17 of the IDDM had clinical characteristics of malnutrition-related diabetes mellitus (MRDM), 36 (56%) of 71 patients were admitted for management. The three most common symptoms of tuberculosis were fever (80.5%), sweating (80.4%) and cough (70.5%). Twenty six (36.6%) of 71 cases were positive for AFB and six (8.5%) were seropositive for HIV. Fifty-six (78.9%) had pulmonary,eight (11.2%) had extrapulmonary and seven(9.8%) had disseminated TB. Forty-eight of 53 abnormal chest x-ray showed unilateral involvement. Thirty-eight of 41 (53.6%) had completed TB treatment, relapse occurred in seven (9.8%), eight (11.2%) are currently on treatment, 13 (18.3%) were lost to follow up, four (5.6%) defaulted and three (4.2%) died. The relative risk of developing TB in IDDM and NIDDM patients was being 26 times and seven times than the general population respectively.
Conclusion:
The prevalence of tuberculosis in the diabetic population is high and this warrants a prospective study to determine association between pulmonary tuberculosis and diabetes.