Alejandro Gómez-Gómez1, Martin Magaña-Aquino2, Salvador López-Meza3, Marcelo Aranda-Álvarez4, Dora E Díaz-Ornelas5, María Guadalupe Hernández-Segura6, Miguel Ángel Salazar-Lezama7, Martín Castellanos-Joya8, Daniel E Noyola9. 1. División de Medicina Interna, Hospital Central "Dr. Ignacio Morones Prieto", San Luis Potosí, México; Departamento de Medicina Interna, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México; Comité Estatal de Tuberculosis Farmacorresistente, San Luis Potosí, México. Electronic address: agomez.cer@prodigy.net.mx. 2. División de Medicina Interna, Hospital Central "Dr. Ignacio Morones Prieto", San Luis Potosí, México; Departamento de Medicina Interna, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México; Comité Estatal de Tuberculosis Farmacorresistente, San Luis Potosí, México. 3. Programa de Atención al Adulto Mayor, San Luis Potosí, México. 4. Dirección de Políticas y Calidad en Salud, San Luis Potosí, México. 5. Programa de Micobacteriosis Servicios de Salud del Estado de San Luis Potosí, San Luis Potosí, México. 6. Servicio de Medicina Preventiva, Hospital Central "Dr. Ignacio Morones Prieto", San Luis Potosí, México. 7. Asesor Nacional en Tuberculosis Farmacorresistente, Instituto Nacional de Enfermedades Respiratorias, México, D.F., México. 8. Dirección Programa Nacional de Tuberculosis, Secretaría de Salud, México, D.F., México. 9. Departmento de Microbiología, Facultad de Medicina, Universidad Autónoma de San Luis Potosí, San Luis Potosí, México.
Abstract
BACKGROUND AND AIMS: Multidrug resistant tuberculosis (MDR-TB) poses problems in treatment, costs and treatment outcomes. It is not known if classically described risk factors for MDR-TB in other countries are the same in Mexico and the frequency of the association between diabetes mellitus (DM) and MDR-TB in our country is not clear. We undertook this study to analyze risk factors associated with the development of MDR-TB, with emphasis on DM. METHODS: A case-control study in the state of San Luis Potosi (SLP), Mexico was carried out. All pulmonary MDR-TB patients diagnosed in the state of SLP between 1998 and 2013 (36 cases) evaluated at a state pharmacoresistant tuberculosis (TB) clinic and committee; 139 controls were randomly selected from all pulmonary non-multidrug-resistant tuberculosis (non-MDR-TB) cases identified between 2003 and 2008. Cases and controls were diagnosed and treated under programmatic conditions. RESULTS: Age, gender, malnutrition, being a health-care worker, HIV/AIDS status, and drug abuse were not significantly different between MDR-TB and non-MDR-TB patients. Significant differences between MDR-TB and non-MDR-TB patients were DM (47.2 vs. 28.1%; p = 0.028); previous anti-TB treatments (3 vs. 0, respectively; p <0.001), and duration of first anti-TB treatment (8 vs. 6 months, respectively; p <0.001). CONCLUSIONS: MDR-TB and DM are associated in 47.2% of MDR TB cases (17/36) in this study. Other recognized factors were not found to be significantly different in MDR-TB compared to non-MDR-TB in this study. Cost-feasible strategies must be implemented in the treatment of DM-TB in order to prevent the selection of MDR-TB.
BACKGROUND AND AIMS: Multidrug resistant tuberculosis (MDR-TB) poses problems in treatment, costs and treatment outcomes. It is not known if classically described risk factors for MDR-TB in other countries are the same in Mexico and the frequency of the association between diabetes mellitus (DM) and MDR-TB in our country is not clear. We undertook this study to analyze risk factors associated with the development of MDR-TB, with emphasis on DM. METHODS: A case-control study in the state of San Luis Potosi (SLP), Mexico was carried out. All pulmonary MDR-TB patients diagnosed in the state of SLP between 1998 and 2013 (36 cases) evaluated at a state pharmacoresistant tuberculosis (TB) clinic and committee; 139 controls were randomly selected from all pulmonary non-multidrug-resistant tuberculosis (non-MDR-TB) cases identified between 2003 and 2008. Cases and controls were diagnosed and treated under programmatic conditions. RESULTS: Age, gender, malnutrition, being a health-care worker, HIV/AIDS status, and drug abuse were not significantly different between MDR-TB and non-MDR-TB patients. Significant differences between MDR-TB and non-MDR-TB patients were DM (47.2 vs. 28.1%; p = 0.028); previous anti-TB treatments (3 vs. 0, respectively; p <0.001), and duration of first anti-TB treatment (8 vs. 6 months, respectively; p <0.001). CONCLUSIONS: MDR-TB and DM are associated in 47.2% of MDR TB cases (17/36) in this study. Other recognized factors were not found to be significantly different in MDR-TB compared to non-MDR-TB in this study. Cost-feasible strategies must be implemented in the treatment of DM-TB in order to prevent the selection of MDR-TB.
Authors: Roula S Zahr; Ryan A Peterson; Linnea A Polgreen; Joseph E Cavanaugh; Douglas B Hornick; Kevin L Winthrop; Philip M Polgreen Journal: BMJ Open Diabetes Res Care Date: 2016-10-10
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Authors: Kevin Montes; Himachandana Atluri; Hibeb Silvestre Tuch; Lucrecia Ramirez; Juan Paiz; Ana Hesse Lopez; Thomas C Bailey; Andrej Spec; Carlos Mejia-Chew Journal: J Clin Tuberc Other Mycobact Dis Date: 2021-11-15