Risk Factors for Pulmonary Tuberculosis in Type II Diabetic patient in Primary Care Unit at Chiang Rai Prachanukroh Hospital

Abstract

Diabetes increases the risk of pulmonary tuberculosis (PTB). Early detection and early treatment of PTB is necessary. Continuously increase number of diabetic patients can be a challenge for Thai public health policy and practice in screening for PTB. Identifying risk factors for PTB among the diabetic patients can be helpful for selective PTB screening policy.

Objective: To determine risk factors for PTB in Diabetic patients in Primary Care Unit at Chiang Rai Prachanukroh Hospital.

Method: A retrospective case-control study was conducted. Medical records of Diabetic patients with PTB (Case group) and Diabetic patients without PTB (Control group) from January 2012- December 2017 were reviewed. Multivariable logistic regression analysis was performed to identify the risk factors and interpreted with adjusted odds ratios (AOR) and 95% of confident intervals (95% CI).

Result: a Total of 205 cases were reviewed. There were 52 cases in case group and 153 cases in control group. This study showed risk factors for PTB in Diabetic patients were: male gender (AOR 3.11; 95%CI 1.33-7.30;p-value =0.009), Body Mass Index (BMI) < 18.4 kg/m² (AOR 80.88; 95% CI 15.77-414.91;p-value=<0.001) HbA1c level at 7.1-8%, 8.1-9% and >9% (AOR1.33; 95% CI 0.45-3.99;p-value=0.605), (AOR2.06; 95% CI 0.66-6.41;p-value=0.210) and (AOR3.78;95% CI 1.25-11.42;p-value=0.018), respectively.

Conclusion: Screening program and routinely monitoring for PTB among diabetic patients should focus on diabetic patients who are male, having poor glycemic control and low BMI. Early detection and early treatment will improve in mortality and control of the PTB.  

Key words   pulmonary tuberculosis, Diabetes, HbA1C, risk factors