Effect of Diabetes Mellitus Comorbidity on Mortality Risk in Tuberculosis Patients who Received Tuberculosis Treatment: A Meta-Analysis
DOI:
https://doi.org/10.26911/jepublichealth.2022.07.04.03Abstract
Background: Tuberculosis or TB is a disease caused by the Mycobacterium tuberculosis complex. There are several comorbidities that experience severity and death when infected with tuberculosis or TB, namely hypertension, diabetes mellitus, cardiovascular disease, chronic kidney disease, cerebrovascular disease, and other diseases. This study aims to estimate the magnitude of the risk of death in Tuberculosis patients undergoing treatment with comorbid Diabetes Mellitus, with a meta-analysis of primary studies conducted by previous authors.
Subjects and Method: This was a systematic review and meta-analysis with the following PICO, population: Tuberculosis patients. Intervention: comorbidities of chronic diabetes mellitus. Comparison: without comorbid diabetes mellitus. Outcome: death. The articles used in this study were obtained from three databases, namely Google Scholar, Pubmed, and Science Direct. Keywords to search for articles “Tuberclosis” OR TBC AND “Diabetes Mellitus” OR DM AND Mortality OR Death The included full-text articles are in English with a cohort study design from 2007 to 2021 and report the adjusted Odds Ratio (aOR) in a multivariate analysis. Article selection is done by using PRISMA flow diagram. Articles were analyzed using the Review Manager 5.3 application.
Results: A total of 12 cohort studies involving tuberculosis patients undergoing treatment from America, Europe, Africa and Asia were selected for a systematic review and meta-analysis. The data collected showed tuberculosis patients undergoing treatment with comorbid Diabetes Mellitus had a 1.68 times risk of death compared to COVID-19 patients without comorbid chronic kidney disease (aOR = 1.68; 95% CI = 1.42 to 1.99; p<0.001).
Conclusion: Diabetes mellitus comorbidity increases the risk of death in tuberculosis patients undergoing treatment.
Keywords: Diabetes Melitus, Tuberculosis, mortality
Correspondence:
Hakim Anasulfalah. Masters Program in Public Health, Universitas Sebelas Maret, Jl. Ir. Sutami 36A, Surakarta 57126, Jawa Tengah. Email: isnanr28@gmail.com. Mobile: 081327215685.
References
ADA (2016). Standards of medical care in diabetes-2016 abridged for primary care providers. Clin Diabetes. 34(1): 3–21. doi: 10.2337/diaclin.34.1.3.
ADA (2018). Improving care and promoting health in populations: standards of medical care in diabetes-2018. Diabetes Care. 41(1): S7–S12. doi: 10.2337/dc18-S001.
Al-Rifai RH, Pearson F, Critchley JA, Abu-Raddad LJ (2017). Association between diabetes mellitus and active Tuberculosis: A systematic review and meta-analysis. PloS one. 12(11): e018-7967. doi: 10.1371/journal.pone.0187967.
Baghaei P, Marjani M, Javanmard P, Tabarsi P, Masjedi MR (2013) Diabetes mellitus and Tuberculosis facts and controversies. J Diabetes Metab Disord. 12 (58): 201-207. doi: 10.1186/2251-6581-12-58.
Baker MA, Harries AD, Jeon CY, Hart JE, Kapur A, Lönnroth K, Ottmani S-E, et al. (2011). The impact of diabetes on Tuberculosis treatment outcomes: a systematic review. BMC Med. 9:81. doi: 10.1186/1741-7015-9-81.
Bertoluci MC, Cé GV, da Silva AM, Wain-stein M V, Boff W, Puñales, M. (2015). Endothelial dysfunction as a predictor of cardiovascular disease in type 1 diabetes. World journal of diabetes. 6(5): 679–692. Doi: 10.4239/wjd.v6.i5.679
CDC (2017). Estimates of diabetes and its burden in the United States. Available at https://www.cdc.gov/dia-betes/pdfs/data/statistics/national-diabetes-statistics-report.pdf. Accessed on 03/06 /2018.
Cochrane (2014). RevMan 5.3 User Guide. Cochrane Library.
Deeks JJ, Hinggins JP, Altman DG (2021). Chapter 10: Analysing data and undertaking meta-analyses | Cochrane Training. Retrieved from https://training.cochrane.org/handbook/current/chapter-10.
Degner NR, Wang JY, Golub JE, Kara-kousis PC (2018). Metformin use reverses the increased mortality associated with diabetes mellitus during Tuberculosis treatment. Arch. Clin. Infect. Dis. 66(2): 198-205. doi: 10.1093/cid/cix819.
Dooley KE, Tang T, Golub JE, Dorman SE (2009). Cronin W. Impact of diabetes mellitus on treatment outcomes of patients with active Tuberculosis. Am J Trop Med Hyg. 80:634-639.
Faurholt‐Jepsen D, Range N, PrayGod G, Jeremiah K, Faurholt‐Jepsen M, Aabye, MG, Changalucha J, et al. (2013). Diabetes is a strong predictor of mortality during Tuberculosis treatment: a prospective cohort study among Tuberculosis patients from M wanza, Tanzania. Trop. Med. Int. Health. 18(7). 822-829. doi: 10.1111/tmi.12120.
Kebede W, Gudina EK, Balay G, Abebe G (2021). Diagnostic implications and inpatient mortality related to Tuberculosis at Jimma Medical Center, southwest Ethiopia. J. Clin. Tuberc. Other Mycobact. Dis. 23. 100220. doi: 10.1016/j.jctube.2021.100220.
Magee MJ, Foote M, Maggjo DM, Howards PP, Narayan KM, Blumberg HM, Ray SM, et al. (2014). Diabetes Mellitus and Risk of All-Cause Mortality among Patients with Tuberculosis in the State of Georgia, 2009–2012 Ann Epidemiol. (24): 369-375. doi: 10.1016/j.annepidem.2014.01.012.
Murti B (2018). Prinsip dan metode riset epidemiologi (5th ed.). Program Studi Ilmu Kesehatan Masyarakat, Program Pascasarjana, Universitas Sebelas Maret.
Perhimpunan Dokter Paru Indonesia (2011) Tuberkulosis: pedoman diagnosis dan penatalaksanaan di Indonesia (Tuberculosis: a guide to diagnosis and management in Indonesia). Jakarta: Indah Offset Citra Grafika. hlm.39-40.
Pradipta IS, Boveneind-Vrubleuskaya N, Akkerman OW, Alffenaar JWC, Hak E (2019). Predictors for treatment outcomes among patients with drug-susceptible Tuberculosis in the Netherlands: a retrospective cohort study. Clin Microbiol Infect. 25(6). 761.e1-761.e7. doi: 10.1016/j.cmi.2018.10.009.
Qian X, Nguyen DT, Lyu J, Albers AE, Bi X, Graviss EA (2018). Risk factors for extrapulmonary dissemination of Tuberculosis and associated mortality during treatment for extrapulmonary Tuberculosis. Emerging microbes & infections. 7(1): 1-14. doi: 10.1038/s41426-018-0106-1.
Rohman H (2018). Kasus tuberkulosis dengan riwayat diabettes mellitus di wilayah prevalensi tinggi diabettes mellitus (Tuberculosis cases with a history of diabetes mellitus in a high prevalence area of diabetes mellitus). Jurnal Manajemen Informasi Kesehatan Indonesia. 6(2): 149 – 156.
Tok PSK, Liew SM, Wong LP, Razali A, Loganathan T, Chinna K, Ismail N, et al. (2020). Determinants of unsuccessful treatment outcomes and mortality among Tuberkulosis patients in Malaysia: A registry-based cohort study. PloS one. 15(4). e02-31986. doi: 10.1371/journal.pone.0231986.
WHO (2017). Treatment Of Tuberculosis Guidelines Fourth Edition. Geneva: WHO Press.
WHO (2018). Global Tuberculosis report Geneva. World Health Organization.
WHO (2019). Global Tuberculosis report Geneva. World Health Organization
