Clinical Outcomes And Economic Burden Of Patients Having Diabetes Mellitus And Tuberculosis In Three Hospitals In Malaysia
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Date
2011-11
Authors
Ishaq Aweis, Daud Moalin
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
The prevalence of diabetes mellitus (DM) in Malaysia is growing to the epidemic level. Since a long time increased susceptibility of diabetic patient to wide range infectious diseases including tuberculosis (TB) has been reported. This study was intended to assess the clinical outcomes and economic burden of combined DM-TB condition. The type of this study is prevalence based prospective cohort. Study patients were divided into three groups: patients with TB infection only; patients with DM only; patients with coexistence of DM and TB. Each group included 200 subjects. Cases (DM-TB) were compared separately with DM only and TB only groups. Patients were first identified as cross-sectional and followed for a minimum of two years. During study period, March 2005-May 2008, each patient's medical file was reviewed at the beginning of the study and at the end of the study. Data collection forms containing required demographic, cost, and clinical information were used. TB patients were classified into pulmonary, extrapulmonary, and patients having both pulmonary and extrapulmonary TB. Prevalence of DM and HIV and other TB risk factors were studied. TB treatment outcome, TB related complications, and TB infectivity period were studied. Durations of hypertension, DM and TB were assessed. Diabetic patients were stratified into three age categories. Prevalence of chronic diseases was studied. A cost of health care resource utilization was studied. The prevalence of HIV and DM among TB patients was 7.7 and 29.9% respectively. Demographically, DM-TB group had more male gender (72%) and smokers (45.5%) compared to 58.3% and 33.5% respectively in TB group. Prevalence of pulmonary TB was more in Chinese (83.7%) and Indians (75.5%) compared to 66.7% in Malays. Smokers were more prevalent in Chinese race, while Indians were more prevalent in alcoholics. Clinically, 74% of DM-TB patients were sputum positive compare to 51% in TB only. About 87% of DM-TB subjects had pulmonary TB compared to 59.5% in TB only group. DM-TB subjects also had more mortality rate (15 cases) compared to 2 cases in TB only group.
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Keywords
Clinical outcomes and economic burden , of patients having diabetes mellitus