The role of diabetes on the clinical manifestations of pulmonary tuberculosis
Tropical Medicine & International Health,  Clinical Article

Faurholt–Jepsen D et al. – Diabetes is associated with small changes in the manifestations of tuberculosis (TB), but may have little clinical significance.

Methods
  • 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.

Results
  • 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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