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Latent TB infection and pulmonary TB disease among patients with diabetes mellitus in Bandung, Indonesia.

Koesoemadinata, RC; McAllister, SM; Soetedjo, NNM; Febni Ratnaningsih, D; Ruslami, R; Kerry, S; Verrall, AJ; Apriani, L; van Crevel, R; Alisjahbana, B; et al. Koesoemadinata, RC; McAllister, SM; Soetedjo, NNM; Febni Ratnaningsih, D; Ruslami, R; Kerry, S; Verrall, AJ; Apriani, L; van Crevel, R; Alisjahbana, B; Hill, PC (2017) Latent TB infection and pulmonary TB disease among patients with diabetes mellitus in Bandung, Indonesia. Trans R Soc Trop Med Hyg, 111 (2). pp. 81-89. ISSN 1878-3503 https://doi.org/10.1093/trstmh/trx015
SGUL Authors: Kerry, Sarah Ruth

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Abstract

Background: Screening and treatment of latent TB infection (LTBI) and TB disease could reduce diabetes mellitus (DM)-associated TB. We aimed to describe the prevalence of LTBI and pulmonary TB among patients with DM in a TB-endemic setting. Methods: Patients with DM attending a hospital and community centres in Bandung, Indonesia, underwent LTBI screening using interferon gamma release assay (IGRA). TB was investigated by sputum smear, culture and x-ray. TB contacts from a parallel study were age- and sex-matched to patients with DM to compare LTBI and TB disease prevalence. Results: Of 682 patients with DM screened, 651 (95.5%) were eligible. Among 'TB disease-free' patients, LTBI prevalence was 38.9% (206/530; 95% CI 34.7-43.2). Patients with DM were less likely to be IGRA positive than TB contacts (38.6%, 54/140; 95% CI 30.5-46.6 vs 68.6%, 96/140; 95% CI 60.9-72.3: p<0.001); but had a higher disease prevalence (4.9%, 8/164; 95% CI 1.6-8.2 vs 1.2%, 2/164; 95% CI -0.5 to 2.9: p=0.054). Patients with DM in crowded households had increased risk of LTBI (AOR 1.71; 95% CI 1.19-2.45). Conclusions: LTBI prevalence in patients with DM was lower than in household contacts, but patients with DM were more likely to have TB disease. Further studies should explore possible benefits of LTBI screening and preventive therapy in patients with DM in TB-endemic settings.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Transactions of The Royal Society of Tropical Medicine and Hygiene following peer review. The version of record Koesoemadinata, RC; McAllister, SM; Soetedjo, NNM; Febni Ratnaningsih, D; Ruslami, R; Kerry, S; Verrall, AJ; Apriani, L; van Crevel, R; Alisjahbana, B; et al. (2017) Latent TB infection and pulmonary TB disease among patients with diabetes mellitus in Bandung, Indonesia. Trans R Soc Trop Med Hyg, 111 (2). pp. 81-89 is available online at: https://doi.org/10.1093/trstmh/trx015
Keywords: Diabetes mellitus, Indonesia, Latent tuberculosis infection, TB disease, Tropical Medicine, 0605 Microbiology, 1108 Medical Microbiology, 1117 Public Health And Health Services
SGUL Research Institute / Research Centre: Academic Structure > Population Health Research Institute (INPH)
Journal or Publication Title: Trans R Soc Trop Med Hyg
ISSN: 1878-3503
Language: eng
Dates:
DateEvent
13 April 2017Published
28 March 2017Accepted
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
305279Seventh Framework Programmehttp://dx.doi.org/10.13039/501100004963
PubMed ID: 28419376
Go to PubMed abstract
URI: http://openaccess.sgul.ac.uk/id/eprint/108853
Publisher's version: https://doi.org/10.1093/trstmh/trx015

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