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BMC Infectious Diseases

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Open Access 01-12-2017 | Research article

Early interventions for diabetes related tuberculosis associate with hastened sputum microbiological clearance in Virginia, USA

Authors: Yosra Alkabab, Suzanne Keller, Denise Dodge, Eric Houpt, Deborah Staley, Scott Heysell

Published in: BMC Infectious Diseases | Issue 1/2017

Abstract

Background

Diabetes complicates tuberculosis (TB) treatment including a prolonged time of sputum culture conversion to negative growth. Since 2013 in Virginia, interventions early in the treatment course have used therapeutic drug monitoring and dose correction for isoniazid and rifampin after 2 weeks of TB treatment in patients with diabetes along with nurse manager initiated diabetes education and linkage to care.

Methods

A retrospective cohort study of the state TB registry was performed for patients initiating drug-susceptible pulmonary TB treatment that were matched for age, gender, chest imaging and sputum smear status to compare time to sputum culture conversion and other clinical outcomes in the pre-and post-intervention groups.

Results

Three hundred sixty-three patients had documented time to sputum culture conversion in the pre-and post-intervention periods, including 56 (15%) with diabetes. Seventy-four (57%) of all patients with diabetes were ≥60 years of age at treatment initiation. Twenty-six patients with diabetes were matched in each group. Mean time to sputum culture conversion in the post-intervention group was 42 ± 22 days compared to the pre-intervention group of 62 ± 31 days (p = 0.01). In the post-intervention group 21 (80%) of patients with diabetes had culture conversion by 2 months compared to 13 (50%) in the pre-intervention group (p = 0.04).

Conclusions

Early interventions for diabetes related TB in the programmatic setting may hasten sputum culture conversion.

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Title: Early interventions for diabetes related tuberculosis associate with hastened sputum microbiological clearance in Virginia, USA
Authors: Yosra Alkabab
Suzanne Keller
Denise Dodge
Eric Houpt
Deborah Staley
Scott Heysell
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI: https://doi.org/10.1186/s12879-017-2226-y

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