The role of diabetes on the clinical manifestations of pulmonary tuberculosis
Tropical Medicine & International Health, 05/21/2012
Faurholt–Jepsen D et al. – Diabetes is associated with small changes in the manifestations of tuberculosis (TB), but may have little clinical significance.
The authors studied 1250 patients with pulmonary TB in an urban population in a cross–sectional study in Tanzania.
All participants were tested for diabetes and HIV co–infection, and TB culture intensity was assessed.
Levels of white blood cells, haemoglobin, acute phase reactants, CD4 count and HIV viral load were measured, and a qualitative morbidity questionnaire was used to identify the prevalence of disease–related symptoms.
Tuberculosis patients with diabetes had a higher neutrophil count (B 0.5 × 109 cells/l, 95% CI 0.2; 0.9, P = 0.001) than non–diabetic TB patients.
Serum C–reactive protein (B 18.8 mg/l, CI 95% 8.2; 29.4, P = 0.001) and alpha–1–acid glycoprotein (B 0.2 g/l, CI 95% 0.03; 0.3, P = 0.02) were similarly higher in patients with diabetes.
Diabetes did not affect culture intensity or HIV status, but self–reported fever was three times higher among participants with diabetes than in those without diabetes (OR 2.9, CI 95% 1.5; 5.7, P = 0.002).
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