1. The Effect of Diabetes and Prediabetes on Antituberculosis Treatment Outcomes: A Multicenter Prospective Cohort Study
- Author
-
Betina Durovni, Bruno B. Andrade, Valeria Cavalcanti Rolla, Alice M S Andrade, Adriano Gomes-Silva, Anna Cristina C. Carvalho, Jaquelane Silva, Betânia Nogueira, Vanessa Nascimento, Marcelo Cordeiro-Santos, Michael S. Rocha, Alysson G Costa, Solange Cavalcante, María B. Arriaga, Marina C. Figueiredo, Elisangela C. Silva, Francine P Ignácio, Beatriz Barreto-Duarte, Megan Turner, Moreno M. S. Rodrigues, Artur T. L. Queiroz, Mariana Araújo-Pereira, Flavia Marinho Sant’Anna, Hayna Malta-Santos, Afrânio Lineu Kritski, Jéssica Rebouças-Silva, Adriana S. R. Moreira, Renata Spener-Gomes, Maria C.S. Lourenço, Aline Benjamin, Mayla Mello, Jamile G. de Oliveira, Maria Vitória C.N.S. Freire, Alexandra B. Souza, Timothy R. Sterling, and José R. Lapa-e-Silva
- Subjects
medicine.medical_specialty ,Treatment outcome ,Antitubercular Agents ,Cohort Studies ,Prediabetic State ,Major Articles and Brief Reports ,Treatment Outcome ,Infectious Diseases ,Geography ,Family medicine ,Diabetes Mellitus ,medicine ,Humans ,Tuberculosis ,Immunology and Allergy ,Prospective Studies - Abstract
Background It is unclear whether diabetes or prediabetes affects unfavorable treatment outcomes and death in people with tuberculosis (PWTB). Methods Culture-confirmed, drug-susceptible PWTB, enrolled in the Regional Prospective Observational Research in Tuberculosis (RePORT)–Brazil cohort between 2015 and 2019 (N = 643) were stratified based on glycemic status according to baseline glycated hemoglobin. Unfavorable tuberculosis (TB) outcome was defined as treatment failure or modification, recurrence, or death; favorable outcome was cure or treatment completion. We corroborated the findings using data from PWTB reported to the Brazilian National System of Diseases Notification (SINAN) during 2015–2019 (N = 20 989). Logistic regression models evaluated associations between glycemic status and outcomes. Results In both cohorts, in univariate analysis, unfavorable outcomes were more frequently associated with smoking, illicit drug use, and human immunodeficiency virus infection. Diabetes, but not prediabetes, was associated with unfavorable outcomes in the RePORT-Brazil (adjusted relative risk [aRR], 2.45; P < .001) and SINAN (aRR, 1.76; P < .001) cohorts. Furthermore, diabetes was associated with high risk of death (during TB treatment) in both RePORT-Brazil (aRR, 2.16; P = .040) and SINAN (aRR, 1.93; P = .001). Conclusions Diabetes was associated with an increased risk of unfavorable outcomes and mortality in Brazilian PWTB. Interventions to improve TB treatment outcomes in persons with diabetes are needed.
- Published
- 2021
- Full Text
- View/download PDF