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Open Access Highly Accessed Research article

The role of diabetes co-morbidity for tuberculosis treatment outcomes: a prospective cohort study from Mwanza, Tanzania

Daniel Faurholt-Jepsen1*, Nyagosya Range2, George Praygod3, Jeremiah Kidola3, Maria Faurholt-Jepsen1, Martine Grosos Aabye4, John Changalucha3, Dirk Lund Christensen56, Torben Martinussen7, Henrik Krarup8, Daniel Rinse Witte6, Åse Bengård Andersen9 and Henrik Friis1

Author Affiliations

1 Department of Human Nutrition, University of Copenhagen, Frederiksberg, Denmark

2 Muhimbili Medical Centre, National Institute of Medical Research, Dar Es Salaam, Tanzania

3 Mwanza Medical Centre, National Institute of Medical Research, Mwanza, Tanzania

4 Clinical Research Centre, University of Copenhagen, Hvidovre Hospital, Hvidovre, Denmark

5 Department of International Health, University of Copenhagen, Copenhagen, Denmark

6 Steno Diabetes Center, Gentofte, Denmark

7 Department of Basic Sciences and Environment, University of Copenhagen, Frederiksberg, Denmark

8 Department of Clinical Biochemistry, Aalborg University Hospital, Aalborg, Denmark

9 Department of Infectious Diseases, Odense University Hospital, Odense, Denmark

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BMC Infectious Diseases 2012, 12:165  doi:10.1186/1471-2334-12-165

Published: 27 July 2012

Abstract

Background

Due to the association between diabetes and pulmonary tuberculosis (TB), diabetes may threaten the control of TB. In a prospective cohort study nested in a nutrition trial, we investigated the role of diabetes on changes in anthropometry, grip strength, and clinical parameters over a five months follow-up period.

Methods

Among pulmonary TB patients with known diabetes status, we assessed anthropometry and clinical parameters (e.g. haemoglobin) at baseline and after two and five months of TB treatment. A linear mixed-effects model (repeated measurements) was used to investigate the role of diabetes during recovery.

Results

Of 1205 TB patients, the mean (standard deviation) age was 36.6 (13.0) years, 40.9% were females, 48.9% were HIV co-infected, and 16.3% had diabetes. TB patients with diabetes co-morbidity experienced a lower weight gain at two (1.3 kg, CI95% 0.5; 2.0, p = 0.001) and five months (1.0 kg, CI95% 0.3; 1.7, p = 0.007). Similarly, the increase in the level of haemoglobin was lower among TB patients with diabetes co-morbidity after two (Δ 0.6 g/dL, CI95% 0.3; 0.9 p < 0.001) and five months (Δ 0.5 g/dL, CI95% 0.2; 0.9 p = 0.004) of TB treatment, respectively.

Conclusion

TB patients initiating TB treatment with diabetes co-morbidity experience delayed recovery of body mass and haemoglobin, which are important for the functional recovery from disease.

Keywords:
Tuberculosis; Diabetes; Treatment outcome; Anthropometry; Haemoglobin; Grip strength