RT Journal Article
SR Electronic
T1 Tuberculosis and Diabetes in Southern Mexico
JF Diabetes Care
JO Diabetes Care
FD American Diabetes Association
SP 1584
OP 1590
DO 10.2337/diacare.27.7.1584
VO 27
IS 7
A1 Ponce-de-Leon, Alfredo
A1 Garcia-Garcia, Ma. de Lourdes
A1 Garcia-Sancho, Ma. Cecilia
A1 Gomez-Perez, Francisco J.
A1 Valdespino-Gomez, Jose Luis
A1 Olaiz-Fernandez, Gustavo
A1 Rojas, Rosalba
A1 Ferreyra-Reyes, Leticia
A1 Cano-Arellano, Bulmaro
A1 Bobadilla, Miriam
A1 Small, Peter M.
A1 Sifuentes-Osornio, Jose
YR 2004
UL http://care.diabetesjournals.org/content/27/7/1584.abstract
AB OBJECTIVE—To determine the impact of diabetes on the rates of tuberculosis in a region where both diseases are prevalent.RESEARCH DESIGN AND METHODS—Data from a population-based cohort of patients with pulmonary tuberculosis undergoing clinical and mycobacteriologic evaluation (isolation, identification, drug-susceptibility testing, and IS6110-based genotyping and spoligotyping) were linked to the 2000 National Health Survey (ENSA2000), a national probabilistic, polystage, stratified, cluster household survey of the civilian, noninstitutionalized population of Mexico.RESULTS—From March 1995 to March 2003, 581 patients with Mycobacterium tuberculosis culture and fingerprint were diagnosed, 29.6% of whom had been diagnosed previously with diabetes by a physician. According to the ENSA2000, the estimated prevalence of diabetes in the study area was 5.3% (95% CI 4.1–6.5). The estimated rates of tuberculosis for the study area were greater for patients with diabetes than for nondiabetic individuals (209.5 vs. 30.7 per 100,000 person-years, P < 0.0001).CONCLUSIONS—In this setting, the rate of tuberculosis was increased 6.8-fold (95% CI 5.7–8.2, P < 0.0001) in patients with diabetes due to increases in both reactivated and recently transmitted infection. Comorbidity with diabetes may increase tuberculosis rates as much as coinfection with human immunodeficiency virus (HIV), with important implications for the allocation of health care resources.