Evaluation of Active Pulmonary Tuberculosis Among Patients With Diabetes

According to several studies, diabetes mellitus has been recognized as one of the main risk factors for pulmonary tuberculosis (PTB). The main purpose of this study was to determine the frequency of smear-positive pulmonary tuberculosis (TB) in patients with diabetes. This cross-sectional study was conducted from April 2010 to December 2011 in Ali Asghar Diabetes Center of Zahedan, Iran. Standard chest radiography and sputum smear examination were performed on patients with diabetes who had signs and symptoms of tuberculosis. Cases of active TB were identified and referred to directly observed treatment, short-course (DOTS) centers. In addition, a purified protein derivative (PPD) skin test was done for all patients. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) software with chi-square and fisher exact test in cross tabulation. Of the 400 patients with diabetes, 24 (6%) patients were suspected to have active PTB, yet laboratory paraclinical examinations revealed 4 cases of smear-positive pulmonary TB. The result of the PPD test was negative (induration of 0-4 mm) in 257 (64.25%) patients, intermediate positive (induration of 5-9 mm) in 118 (29.5%) and positive (induration of 10-14 mm) in 25 (6.25%) cases. The results of this study indicate high frequency of smear-positive TB in patients with diabetes, compared with expected cases in the community and global population. Thus, screening of tuberculosis in patients with diabetes is recommended for the control and successful treatment of the two diseases