Diabetes Mellitus as a Risk Factor for Drug Resistance Tuberculosis: A Retrospective Cohort Study at King Abdul Aziz University, Jeddah
Sumyia Mehrin M. D. Abulkalam *
Department of Public Health, King Abdulaziz University (Bachelor's in Medicine and Bachelor's in Surgery), Saudi Arabia.
Mai Kadi
Department of Community Medicine, King Abdulaziz University, Saudi Arabia.
Mahmoud A. Gaddoury
Department of Community Medicine, King Abdulaziz University, Saudi Arabia.
Wallaa Khalid Albishi
Department of Public health, King Abdulaziz University (Bachelor's in Dental Medicine and Bachelor's in Surgery), Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Background: The association between tuberculosis (TB) and diabetes mellitus (DM) is re-emerging with the epidemic of type II diabetes. Both TB and DM were of the top 10 causes of death.[1] This study explores diabetes mellitus as a risk factor for developing the different antitubercular drug-resistant (DR) patterns among TB patients.
Methods: A retrospective cohort study has been conducted on all TB cases reported to the King Abdul Aziz University Hospital, Jeddah, between January 2012 to January 2021. All culture-confirmed and PCR-positive TB cases were included in this study. Categorical baseline characteristic of TB patient has been compared with DM status by using Fisher's exact and Pearson chi-square test. The univariable and multivariable logistic regression model was used to estimate the association between DM and different drug resistance patterns.
Results: Of the total 695 diagnosed TB patients, 92 (13.24%) are resistant to 1st line anti TB drugs. Among 92 DR-TB patients, 36 (39.13%) are diabetic. The percentage of different patterns of DR-TB with DM, in the case of mono DR (12.09%), poly DR (4.19%) MDR (0.547%). As a risk factor, DM has a significant association with DR-TB, mono drug-resistant, and pyrazinamide-resistant TB (P-value <0.05). The MDR and PDR separately do not show any significant association with DM, but for further analysis, it shows a significant association with DM when we combined.
Conclusion: Our study identified diabetes mellitus as a risk factor for developing DR-TB. Better management of DM and TB infection caring programs among DM patients might improve TB control and prevent DR-TB development in KSA.
Keywords: Tuberculosis, drug resistance, diabetes, the risk factor, KSA