Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study

Detalhes bibliográficos
Autor(a) principal: Santana, Leonardo Gil
Data de Publicação: 2016
Outros Autores: Almeida Junior, Jilson Leão de, Oliveira, Carolina A. M, Hickson, Lucas S, Daltro, Carla Hilário da Cunha, Castro, Simone, Kornfeld, Hardy, Martins Netto, Eduardo, Andrade, Bruno de Bezerril
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/17733
Resumo: Intramural Research Program of the Fundação Oswaldo Cruz (FIOCRUZ).
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spelling Santana, Leonardo GilAlmeida Junior, Jilson Leão deOliveira, Carolina A. MHickson, Lucas SDaltro, Carla Hilário da CunhaCastro, SimoneKornfeld, HardyMartins Netto, EduardoAndrade, Bruno de Bezerril2017-02-08T14:22:04Z2017-02-08T14:22:04Z2016SANTANA, L. G. et al. Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study. Plos One, v. 11, n. 1, p. e0146876, 2016.1932-6203https://www.arca.fiocruz.br/handle/icict/1773310.1371/journal.pone.0146876Intramural Research Program of the Fundação Oswaldo Cruz (FIOCRUZ).Fundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório Integrado de Microbiologia e Imunorregulação. Unidade de Medicina Investigativa. Salvador, BA, Brasil / Faculdades de Tecnologia e Ciências, School of Medicine. Salvador, Bahia, Brazil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, BrazilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório Integrado de Microbiologia e Imunorregulação. Unidade de Medicina Investigativa. Salvador, BA, Brasil / Faculdades de Tecnologia e Ciências, School of Medicine. Salvador, Bahia, Brazil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, BrazilFundação José Silveira. Research Center. Instituto Brasileiro para Investigação da Tuberculose (IBIT). Salvador, BA, BrasilFundação José Silveira. Research Center. Instituto Brasileiro para Investigação da Tuberculose (IBIT). Salvador, BA, BrasilUniversidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Salvador, BA, BrasilFundação José Silveira. Research Center. Instituto Brasileiro para Investigação da Tuberculose (IBIT). Salvador, BA, BrasilUniversity of Massachusetts Medical School. Department of Medicine. Worcester, Massachussetts, USAFundação José Silveira. Research Center. Instituto Brasileiro para Investigação da Tuberculose (IBIT). Salvador, BA, Brasil / Universidade Federal da Bahia. Hospital Universitário Professor Edgard Santos. Salvador, BA, BrasilFundação Oswaldo Cruz. Centro de Pesquisas Gonçalo Moniz. Laboratório Integrado de Microbiologia e Imunorregulação. Unidade de Medicina Investigativa. Salvador, BA, Brasil / Faculdades de Tecnologia e Ciências, School of Medicine. Salvador, Bahia, Brazil / Fundação José Silveira. Multinational Organization Network Sponsoring Translational and Epidemiological Research (MONSTER) Initiative. Salvador, BA, Brazil / Fundação José Silveira. Research Center. Instituto Brasileiro para Investigação da Tuberculose (IBIT). Salvador, BA, BrasilThe rising prevalence of diabetes mellitus (DM) worldwide, especially in developing countries, and the persistence of tuberculosis (TB) as a major public health issue in these same regions, emphasize the importance of investigating this association. Here, we compared the clinical profile and disease outcomes of TB patients with or without coincident DM in a TB reference center in Brazil. Methods We performed a retrospective analysis of a TB patient cohort (treatment naïve) of 408 individuals recruited at a TB primary care center in Brazil between 2004 and 2010. Data on diagnosis of TB and DM were used to define the groups. The study groups were compared with regard to TB disease presentation at diagnosis as well as to clinical outcomes such as cure and mortality rates upon anti-tuberculosis therapy (ATT) initiation. A composite score utilizing clinical, radiological and microbiological parameters was used to compare TB severity between the groups. Results DM patients were older than non-diabetic TB patients. In addition, diabetic individuals more frequently presented with cough, night sweats, hemoptysis and malaise than those without DM. The overall pattern of lung lesions assessed by chest radiographic examination was PLOS similar between the groups. Compared to non-diabetic patients, those with TB-diabetes exhibited positive acid-fast bacilli in sputum samples more frequently at diagnosis and at 30 days after ATT initiation. Notably, higher values of the TB severity score were significantly associated with TB-diabetes comorbidity after adjustment for confounding factors. Moreover, during ATT, diabetic patients required more frequent transfers to TB reference hospitals for complex clinical management. Nevertheless, overall mortality and cure rates were indistinguishable between the study groups. Conclusions These findings reinforce the idea that diabetes negatively impacts pulmonary TB severity. Our study argues for the systematic screening for DM in TB reference centers in endemic areas.porPublic Library of ScienceDiabetes MellitusComplicações do DiabetesHumanosAdultosPrevalênciaFemininoFatores de RiscoTuberculose PulmonarDiabetes MellitusDiabetes ComplicationsAdultHumansFemalePrevalenceRisk FactorsTuberculosis, PulmonaryDiabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/17733/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALGil-Santana L Diabetes is associated....pdfGil-Santana L Diabetes is 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dc.title.pt_BR.fl_str_mv Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study
title Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study
spellingShingle Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study
Santana, Leonardo Gil
Diabetes Mellitus
Complicações do Diabetes
Humanos
Adultos
Prevalência
Feminino
Fatores de Risco
Tuberculose Pulmonar
Diabetes Mellitus
Diabetes Complications
Adult
Humans
Female
Prevalence
Risk Factors
Tuberculosis, Pulmonary
title_short Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study
title_full Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study
title_fullStr Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study
title_full_unstemmed Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study
title_sort Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study
author Santana, Leonardo Gil
author_facet Santana, Leonardo Gil
Almeida Junior, Jilson Leão de
Oliveira, Carolina A. M
Hickson, Lucas S
Daltro, Carla Hilário da Cunha
Castro, Simone
Kornfeld, Hardy
Martins Netto, Eduardo
Andrade, Bruno de Bezerril
author_role author
author2 Almeida Junior, Jilson Leão de
Oliveira, Carolina A. M
Hickson, Lucas S
Daltro, Carla Hilário da Cunha
Castro, Simone
Kornfeld, Hardy
Martins Netto, Eduardo
Andrade, Bruno de Bezerril
author2_role author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Santana, Leonardo Gil
Almeida Junior, Jilson Leão de
Oliveira, Carolina A. M
Hickson, Lucas S
Daltro, Carla Hilário da Cunha
Castro, Simone
Kornfeld, Hardy
Martins Netto, Eduardo
Andrade, Bruno de Bezerril
dc.subject.other.pt_BR.fl_str_mv Diabetes Mellitus
Complicações do Diabetes
Humanos
Adultos
Prevalência
Feminino
Fatores de Risco
Tuberculose Pulmonar
topic Diabetes Mellitus
Complicações do Diabetes
Humanos
Adultos
Prevalência
Feminino
Fatores de Risco
Tuberculose Pulmonar
Diabetes Mellitus
Diabetes Complications
Adult
Humans
Female
Prevalence
Risk Factors
Tuberculosis, Pulmonary
dc.subject.en.pt_BR.fl_str_mv Diabetes Mellitus
Diabetes Complications
Adult
Humans
Female
Prevalence
Risk Factors
Tuberculosis, Pulmonary
description Intramural Research Program of the Fundação Oswaldo Cruz (FIOCRUZ).
publishDate 2016
dc.date.issued.fl_str_mv 2016
dc.date.accessioned.fl_str_mv 2017-02-08T14:22:04Z
dc.date.available.fl_str_mv 2017-02-08T14:22:04Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.citation.fl_str_mv SANTANA, L. G. et al. Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study. Plos One, v. 11, n. 1, p. e0146876, 2016.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/17733
dc.identifier.issn.pt_BR.fl_str_mv 1932-6203
dc.identifier.doi.none.fl_str_mv 10.1371/journal.pone.0146876
identifier_str_mv SANTANA, L. G. et al. Diabetes Is Associated with Worse Clinical Presentation in Tuberculosis Patients from Brazil: A Retrospective Cohort Study. Plos One, v. 11, n. 1, p. e0146876, 2016.
1932-6203
10.1371/journal.pone.0146876
url https://www.arca.fiocruz.br/handle/icict/17733
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publisher.none.fl_str_mv Public Library of Science
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