TY - JOUR
T1 - Diabetes and pre-diabetes among household contacts of tuberculosis patients in India
T2 - Is it time to screen them all?
AU - CTRIUMPh-RePORT India Study Team
AU - Shivakumar, S. V.B.Y.
AU - Chandrasekaran, P.
AU - Kumar, A. M.V.
AU - Paradkar, M.
AU - Dhanasekaran, K.
AU - Suryavarshini, N.
AU - Thomas, B.
AU - Kohli, R.
AU - Thiruvengadam, K.
AU - Kulkarni, V.
AU - Hannah, L. E.
AU - Sivaramakrishnan, G. N.
AU - Pradhan, N.
AU - Dolla, C.
AU - Gupte, A.
AU - Ramachandran, G.
AU - DeLuca, A.
AU - Meshram, S.
AU - Bhardawaj, R.
AU - Bollinger, R. C.
AU - Golub, J.
AU - Selvaraj, K.
AU - Gupte, N.
AU - Swaminathan, S.
AU - Mave, V.
AU - Gupta, A.
N1 - Publisher Copyright:
© 2018 The Union.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Setting: Pre-diabetes mellitus (pre-DM) and DM increase the risk of developing tuberculosis (TB). Screening contacts of TB patients for pre-DM/DM and linking them to care may mitigate the risk of developing TB and improve DM management. Objective : To measure the prevalence of pre-DM/DM and associated factors among the adult household contacts (HHCs) of pulmonary TB patients. Methods : Between August 2014 and May 2017, adult HHCs of newly diagnosed adult PTB patients in Pune and Chennai, India, had single blood samples tested for glycosylated haemoglobin (HbA1c) at enrolment. DM was defined as previously diagnosed, self-reported DM or HbA1c ≥6.5%, and pre-DM as HbA1c between 5.7% and 6.4%. Latent tuberculous infection (LTBI) was defined as a positive tuberculin skin test (≥5 mm induration) or QuantiFERON® Gold In-Tube (≥0.35 international units/ml). Results : Of 652 adult HHCs, 175 (27%) had pre-DM and 64 (10%) had DM. Forty (64%) HHCs were newly diagnosed with DM and 48 (75%) had poor glycaemic control (HbA1c ≥7.0%). Sixty-eight (22%) pre-DM cases were aged 18-34 years. Age≥35 years, body mass index ≥25 kg/m 2 , chronic disease and current tobacco smoking were significantly associated with DM among HHCs. Conclusions : Adult HHCs of TB patients in India have a high prevalence of undiagnosed DM, pre-DM and LTBI, putting them at high risk for developing TB. Routine DM screening should be considered among all adult HHCs of TB.
AB - Setting: Pre-diabetes mellitus (pre-DM) and DM increase the risk of developing tuberculosis (TB). Screening contacts of TB patients for pre-DM/DM and linking them to care may mitigate the risk of developing TB and improve DM management. Objective : To measure the prevalence of pre-DM/DM and associated factors among the adult household contacts (HHCs) of pulmonary TB patients. Methods : Between August 2014 and May 2017, adult HHCs of newly diagnosed adult PTB patients in Pune and Chennai, India, had single blood samples tested for glycosylated haemoglobin (HbA1c) at enrolment. DM was defined as previously diagnosed, self-reported DM or HbA1c ≥6.5%, and pre-DM as HbA1c between 5.7% and 6.4%. Latent tuberculous infection (LTBI) was defined as a positive tuberculin skin test (≥5 mm induration) or QuantiFERON® Gold In-Tube (≥0.35 international units/ml). Results : Of 652 adult HHCs, 175 (27%) had pre-DM and 64 (10%) had DM. Forty (64%) HHCs were newly diagnosed with DM and 48 (75%) had poor glycaemic control (HbA1c ≥7.0%). Sixty-eight (22%) pre-DM cases were aged 18-34 years. Age≥35 years, body mass index ≥25 kg/m 2 , chronic disease and current tobacco smoking were significantly associated with DM among HHCs. Conclusions : Adult HHCs of TB patients in India have a high prevalence of undiagnosed DM, pre-DM and LTBI, putting them at high risk for developing TB. Routine DM screening should be considered among all adult HHCs of TB.
KW - Diabetes
KW - LTBI
KW - Latent tuberculous infection
KW - Pre-diabetes
KW - Screening
KW - TB contacts
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U2 - 10.5588/ijtld.17.0598
DO - 10.5588/ijtld.17.0598
M3 - Article
C2 - 29862955
AN - SCOPUS:85046965125
SN - 1027-3719
VL - 22
SP - 686
EP - 694
JO - International Journal of Tuberculosis and Lung Disease
JF - International Journal of Tuberculosis and Lung Disease
IS - 6
ER -