Diabetes and other risk factors for multi-drug resistant tuberculosis in a mexican population with pulmonary tuberculosis: Case control study
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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%25; p=0.028); previous anti-TB treatments (3 vs. 0, respectively; p<0.001), and duration of first anti-TB treatment (8 vs. 6months, respectively; p<0.001). Conclusions: MDR-TB and DM are associated in 47.2%25 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. © 2015 IMSS.
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Diabetes; Latin America; MDR-TB tuberculostatic agent; isoniazid; rifampicin; tuberculostatic agent; acquired immune deficiency syndrome; adult; age; antibiotic sensitivity; Article; controlled study; diabetes mellitus; drug abuse; female; health care personnel; human; Human immunodeficiency virus infected patient; Human immunodeficiency virus infection; infection risk; lung tuberculosis; major clinical study; male; malnutrition; Mexican; multidrug resistant tuberculosis; polymerase chain reaction; population based case control study; sex difference; smoking; sputum culture; treatment duration; bacterium identification; case control study; diabetes mellitus; drug effects; genetics; health care cost; Mexico; microbial sensitivity test; microbiology; middle aged; mortality; multidrug resistance; Mycobacterium tuberculosis; outpatient department; pathology; risk factor; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary; Adult; Ambulatory Care Facilities; Antibiotics, Antitubercular; Bacterial Typing Techniques; Case-Control Studies; Diabetes Complications; Diabetes Mellitus; Drug Resistance, Multiple, Bacterial; Female; Health Care Costs; Health Personnel; Humans; Isoniazid; Male; Mexico; Microbial Sensitivity Tests; Middle Aged; Mycobacterium tuberculosis; Rifampin; Risk Factors; Tuberculosis, Multidrug-Resistant; Tuberculosis, Pulmonary
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