Latent tuberculosis in patients with diabetes mellitus: prevalence, progression and public health implications

M. K S Leow, R. Dalan, Cynthia Bin Eng Chee, A. Earnest, D. E K Chew, A. W K Tan, W. Y C Kon, M. D. de Jong, T. Barkham, Y. T. Wang

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21 Citations (Scopus)

Abstract

BACKGROUND: Diabetes mellitus (DM) confers a higher risk for tuberculosis (TB). Yet, TB screening and chemoprophylaxis for latent TB infection (LTBI) in DM remains controversial. We conducted a cross-sectional study to elucidate LTBI prevalence and longitudinal follow-up to ascertain LTBI to active TB progression rate in DM. METHODS: 220 DM patients without previous TB from the outpatient diabetes clinic of the hospital were enrolled. T-Spot TB, tuberculin-skin-test (TST) and chest radiography (CXR) were performed. LTBI was defined by negative CXR with reactive T-Spot TB. Progression to active TB was confirmed by cross-checking against the TB registry. RESULTS: The prevalence of LTBI was 28.2% (62/220) by reactive T-Spot. None progressed to active TB from 2007-2013. Multivariate analysis revealed that any co-morbidity (p=0.016) was positively associated while metformin (p=0.008) was negatively associated with LTBI. CONCLUSIONS: Over a quarter of DM patients harbor LTBI. While the lack of demonstrable progression to active TB within the follow-up time frame up to this point does not unequivocally support a routine TB screening policy or anti-TB chemoprophylaxis for LTBI in a diabetic population for now, this preliminary evidence needs re-evaluation with longer follow-up of this enrolled cohort over the next decade.

Original languageEnglish
Pages (from-to)528-532
Number of pages5
JournalExperimental and Clinical Endocrinology and Diabetes
Volume122
Issue number9
DOIs
Publication statusPublished - Oct 2014
Externally publishedYes

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