Millions of diabetics could die of tuberculosis
Public Health Risk
A third of the world’s human population is infected with a dormant tuberculosis bacteria, primarily people living in developing countries. The bacteria presents a lifelong TB risk. Recent research out of the University of Copenhagen demonstrates that the risk of tuberculosis breaking out is four times as likely if a person also suffers from diabetes. Meanwhile, as a diabetic, a person is five times as likely to die during tuberculosis treatment. The growing number of diabetics in Asia and Africa increases the likelihood that more people will succumb to and die from tuberculosis in the future.
A research group from the Faculty of Science at the University of Copenhagen has just completed a major research project in Tanzania in which they have documented that diabetes is far more widespread than previously thought.
Diabetes hastily advancing in developing countries
The risk of dying from tuberculosis is increased if a person also has diabetes. In the past, diabetes was most commonly associated with the Western world while tuberculosis was more widespread throughout the developing world.
“Our studies show, firstly, that diabetes is hastily advancing in developing countries, not just in Asia, but in Africa as well. And secondly, that as a diabetic one is four times more at risk of developing tuberculosis and five times as likely to die under tuberculosis treatment,” reports PhD student and physician Daniel Faurholt-Jepsen who has written his doctoral dissertation on the basis of the study.
Need to bolster preventative regimens
With the dramatic increase in the spread of diabetes, even among the poorest, there is a need to strengthen prevention. The results of the study demonstrate that diabetes is a severe threat to the control of tuberculosis:
“Tuberculosis kills more than a million people each year. The figure may be much higher in the future if nothing is done now. We should develop better international guidelines for a combined treatment of diabetes and tuberculosis patients as well as better diagnostic methods, which can cheaply and effectively diagnose diabetes among tuberculosis patients,” emphasises Daniel Faurholt-Jepsen.
The study was conducted in the northern Tanzanian city of Mwanza, home to more than a million people.
Daniel Faurholt-Jepsen defended his PhD dissertation ‘The Double Burden: The role of diabetes for tuberculosis risk, manifestations, treatment outcomes and survival’ on July 6 at the University of Copenhagen’s Faculty of Science.
Doctor, PhD Daniel Faurholt-Jepsen, mobile: 26 74 12 42
Doctor, PhD Daniel Faurholt-Jepsen
The Faculty of Science
University of Copenhagen
Mobile: +45 26 74 12 42
Communications Officer Carl Hagman
University of Copenhagen
Mobile: +45 21 62 34 31
About the Mwanza field study
The study was primarily designed to assess the role of diabetes in tuberculosis risk, treatment results and survival among a Tanzanian population composed of tuberculosis patients and a non-tuberculosis control group.
Tuberculosis and HIV are common infections in the region. However, there is a shortage of knowledge related to the spread of diabetes. Researchers recruited newly diagnosed pulmonary tuberculosis patients from spring 2006 until autumn 2009.
All participants in the study underwent diabetes and HIV testing as well as measurements of anthropometric, clinical and paraclinical parameters. The patients were followed up on during tuberculosis treatment (after 2 and 5 months) to assess their treatment outcome as well as after one year to assess their rate of survival.
Based on the study of 1250 tuberculosis patients and the 350 non-tuberculosis control subjects, researchers were able to find out that 38% and 21% respectively had impaired glucose metabolism and that the incidence of diabetes was 17% and 9% respectively among tuberculosis patients and the control group.
This difference in the incidence rate between patients and the control group corresponded to an odds-ratio of more than four, indicating a strong association between tuberculosis and diabetes. Researchers were also able to ascertain that diabetes was associated with both HIV-positive and HIV–negative participants. Patients with diabetes had a four times higher mortality rate whilst under the intensive phase of tuberculosis treatment.
The combination of tuberculosis and diabetes in the African region is a mounting health problem that could translate into another increase in the incidence of tuberculosis.