INTRODUCTION: Tuberculosis has been a cause of significant morbidity and mortality for humans throughout history. There are 20 million cases of tuberculosis worldwide with 8 million new cases each year. Three million deaths annually are directly attributable to tuberculosis. Previous clinic-based studies in developed countries demonstrated an association between tuberculosis and diabetes but did not determine whether this is attributable an increase in recently transmitted or reactivated infection of tuberculosis.
OBJECTIVE: The objective of this study was to identify the epidemiologic relationship between tuberculosis and diabetes in children by using MycoDot, a simple, rapid, and reliable test.
METHODS: This study was a cross-sectional study of 2 groups. The first group was 110 children who had type 1 diabetes, were aged 5 to 10 years, and had a regular follow-up in the pediatric diabetes outpatient clinic in Elminia University Hospital. The second group consisted of 110 children (as a control group without diabetes) who were age and gender matched from the pediatric outpatient clinic in Elminia University Hospital. The children were subjected to tuberculin skin test and Ziehl Neelsen staining on sputum. The children with diabetes only were subjected to chest radiograph. The children's sera were subjected to MycoDot test.
RESULTS: Among the 110 children with diabetes, 6 (5.5%) were determined to have positive tuberculosis results using the MycoDot technique. Only 1 (0.9%) control patient was determined to have a positive tuberculosis result using the same test. Among the children with diabetes (110), 4 (3.8%) were found to have positive tuberculosis results by tuberculin skin test, whereas 2 (1.8%) were found to have positive tuberculosis results by Ziehl Neelsen staining on sputum.
CONCLUSIONS: Many studies have explored the association between diabetes and tuberculosis. In developed countries, studies dating to the first half of the 20th century demonstrated considerable increase in the frequency of tuberculosis among patients with diabetes, although the proportion with comorbidity ranged widely from 1.0% to 9.3%. Other studies have shown a higher frequency of diabetes among individuals with tuberculosis. In our results, 5.5% of children with diabetes had tuberculosis by MycoDot test, which is a simple and reliable test, whereas only 1 (0.9%) positive result was found in the group without diabetes by the same test. The former indicates that risk for tuberculosis increases among children with diabetes, which indicates that regular screening for the presence of active tuberculosis among children with diabetes should be conducted.
Submitted by Basma Abdelmoez
- Copyright © 2008 by the American Academy of Pediatrics