Factors Associated with Smear Positive Pulmonary Tuberculosis among Diabetes Mellitus Patients in Thailand: a Meta-Analysis

Abstract

We performed a systematic review and meta-analysis with the aim to summarizing the risk factors associated with smear positive pulmonary tuberculosis (PTB) among diabetes mellitus (DM) patients in Thailand. We searched e-Journals, hand searching in Thai academic libraries and contacted peer reviewed. We included seven studies and choosed a prior to use the fixed effect model described by Mantel Haenszel and use the random effects model by DerSimonian and Laird as we expected the pooled odds ratio effects (POR) and 95%CI.

The ten factors associated with smear positive PTB among DM patients in Thailand were: household contact with a TB patients (POR = 6.08; 95%CI = 3.61 - 10.25), ever being in close contact with a TB patients (POR = 4.07; 95%CI = 2.73 - 6.06), HbA1c levels ≥ 7.0% (POR = 4.76; 95%CI = 3.45 - 6.58), ever been admitted in hospital (POR = 3.44; 95%CI = 1.44 - 8.33), live in overcrowded housing (POR = 2.44; 95%CI = 1.62 - 3.68), alcohol consumption (POR = 2.21; 95%CI = 1.44 - 3.41), smoking (POR = 2.03; 95%CI = 1.64 - 2.51), duration of DM ≥ 10 years (POR = 1.97; 95%CI = 1.40 - 2.78) patient’s income less than 5,000 baht/month (POR = 1.89; 95%CI = 1.41-2.54), and had stress during past 6 months (POR = 1.70; 95%CI = 1.16 - 2.48).

In conclusion, screening and active case finding of new PTB cases among DM patients with an increased risk PTB. Especially, the DM patients had household contact with a PTB patient, had ever been in closed contact with a PTB patient and had HbA1c levels ≥ 7.0 % should be done to improve, the detection and early treatment of PTB and to prevent the transmission of PTB in the community, Thailand.