Factors associated with pulmonary tuberculosis among Diabetes mellitus patients in North-Eastern Thailand

Abstract

This study is an unmatched case-control study which aims to identify factors related to pulmonary tuberculosis (PTB) among diabetes mellitus (DM) patients in north-eastern Thailand. The study was conducted in DM outpatients of diabetes clinics in seven provinces in north-eastern Thailand , (Yasothon , Nong Khai, Buri Ram, Sakon Nakhon, Chaiyaphum, Roi Et and Nakhon Ratchasima), Data were collected during the period 1 October 2008 to 30 September 2014. The population selected for this research was 2,382 DM patients and two groups: 786 PTB patients (the case group) and 1,596 non-TB patients (the control group). Descriptive statistics was applied to identify characteristics. The relationship values of single variables were determined through univariate analyses: crude odds ratio (OR). A multiple logistic regression was analysed, then performed to adjust OR value OR ) at a 95% confidence interval (95% CI).

The result showed that,  Most 2,382 DM patients are women 57.43 % and mean of age is 59.12 years old (SD.=10.89.The univariate analysis showed that the risk factors related to PTB among diabetes patients with a significant P-value (P-value < 0.05) were: being the analysis of multiple variable logistic regression showed the factors significantly associated with TB in Diabetes patients : male (OR  = 1.49, 95 % CI = 1.22-1.82 ) unemploying (OR = 1.33, 95 % CI = 1.01-1.75 ) having income less than 5,000 bath (OR   = 1.51, 95 % CI = 1.21-1.89 ) BMI exceeding 18.5 kg/m  (OR   = 2.85, 95 % CI = 1.87-3.55 ) smoking (OR  = 1.45, 95 % CI = 1.16-1.81 ) type 2 Diabetes (OR   = 1.85, 95 % CI = 1.25-2.74 ) having a level of hemoglobin A1c (HbA_1c) more than 7.0 mg% (OR   = 2.66, 95 % CI = 2.09-3.38 ) having TB history (OR   = 11.71, 95 % CI = 7.20-19.02 ) living in the same house as a TB patient (OR   = 3.72, 95 % CI = 2.83-4.86)

In conclusion, the factors associated with pulmonary tuberculosis among Diabetes Mellitus is patients in north-eastern Thailand. There are a variety of factors. Then health service about disease prevention and affordable healthcare. There should be a system of surveillance and screening for new tuberculosis cases in diabetes patient and non-communicable diseases; NCDs clinic at hospital and primary health care unit for systematically and continuously.