Dr Yasir Irfat, Dr Ahmed Jamshaid, Dr Marriam Sarfraz
Background: Tuberculosis is a major cause of morbidity and mortality and diabetes is a leading risk factor of tuberculosis. Co-existence of tuberculosis and diabetes may increase the disease severity and worsen the treatment outcome. Objective: The objective is to find the anti-tuberculosis treatment outcome among pulmonary tuberculosis patients with or without diabetes mellitus and to see the drug resistance pattern among treatment failure cases in both groups. Study Design: A cross-sectional study. Place and Duration: This study was conducted in Services hospital Lahore for the duration of one year from December, 2018 to November, 2019. Methodology: The data of 268 patients including 187 pulmonary tuberculosis patients without diabetes and 81 with diabetes was analyzed. Anti-tuberculosis treatment according to current guidelines of Directly Observed Therapy (DOT) was provided to all patients and were assessed for improvement of AFB smear, AFB culture and Chest X-Ray before and after four months of starting ATT. Data were analyzed by using Statistical Package for Social Sciences version 20. Results: Mean age of non-diabetic TB patients was 36±16 years; and of diabetic TB patients was 50±12 years. Mean duration of diabetes was 6±4 years. Other characteristics included 57.8% males, 42.2% females, and 53.7% had history of contact. Cough, expectoration, fever and weight loss were commonly occurring symptoms. Infiltration (76.1%) was the commonest type of lesion followed by consolidation (14.6%) and cavitation (9.3%). Findings of AFB Smear conversion, AFB Culture, and Chest X-ray were improved with time in both groups; and rates of improvement were significantly higher among non-diabetic TB patients (p <0.05). The frequency of drug resistance was lower among non-diabetic TB patients (7.0% vs. 19.8%) but the difference was insignificant. The rates of drug resistance and MDR were considerably higher among patients with poor glycemic control (p 0.036). Conclusion: Therapeutic outcome of pulmonary tuberculosis was poor among diabetic TB patients as compare to non-diabetic TB patients. Therefore, along with anti-tuberculosis treatment, improvement of glycemic control must be considered among diabetic TB patients for better treatment outcome and reduced drug resistance rate. Keywords: Therapeutics outcome, MDR, TB with diabetes, glycemic control.