The Effect of Diabetes and Prediabetes on Antituberculosis Treatment Outcomes: A Multicenter Prospective Cohort Study

Abstract

Methods: Culture-confirmed, drug-susceptible PWTB from the RePORT-Brazil cohort ($N=643$) and the Brazilian National System of Diseases Notification (SINAN) ($N=20,989$) were stratified by glycemic status. Unfavorable outcome included treatment failure, modification, recurrence, or death. Logistic regression models evaluated associations between glycemic status and outcomes.

Results: In both cohorts, diabetes was independently associated with unfavorable outcomes (RePORT-Brazil: aRR, 2.45; SINAN: aRR, 1.76) and a higher risk of death during treatment (RePORT-Brazil: aRR, 2.16; SINAN: aRR, 1.93). Prediabetes was not significantly associated with unfavorable outcomes or death. Unfavorable outcomes were also frequently associated with smoking, illicit drug use, and HIV infection.

Conclusions: Diabetes, but not prediabetes, was associated with an increased risk of unfavorable outcomes and mortality in Brazilian PWTB. These findings highlight the need for systematic laboratory investigation of diabetes in TB cases and targeted interventions to improve treatment success.

Keywords: diabetes; prediabetes; treatment outcome; SINAN; Mycobacterium tuberculosis.

Clique aqui

• Data de Publicação: 15/10/2021
• Autores: María B. Arriaga, 1,2,3,a Mariana Araújo-Pereira, 1,2,3,a Beatriz Barreto-Duarte, 1,2,4,a Betânia Nogueira, 2,3,5,a Maria Vitória C. N. S. Freire, 6 Artur T. L. Queiroz, 2,7 Moreno M. S. Rodrigues, 8 Michael S. Rocha, 2,5 Alexandra B. Souza, 9,10 Renata Spener-Gomes, 9,10,11 Anna Cristina C. Carvalho, 12,13 Marina C. Figueiredo, 14 Megan M. Turner, 14 Betina Durovni, 15 José R. Lapa-e-Silva, 12 Afrânio L. Kritski, 12 Solange Cavalcante, 15 Valeria C. Rolla, 16 Marcelo Cordeiro-Santos, 9,10,17 Timothy R. Sterling, 14 and Bruno B. Andrade, 1,2,3,4,6,14, ;