The impact of diabetes mellitus on the emergence of multi-drug resistant tuberculosis and treatment failure in TB-diabetes comorbid patients: a systematic review and meta-analysis

被引:20
作者
Rehman, Anees ur [1 ]
Khattak, Mahnoor [1 ]
Mushtaq, Usman [2 ]
Latif, Muhammad [3 ]
Ahmad, Imran [4 ]
Rasool, Muhammad Fawad [1 ]
Shakeel, Sadia [5 ]
Hayat, Khezar [6 ]
Hussain, Rabia [7 ]
Alhazmi, Ghaidaa Ali [8 ]
Alshomrani, Afnan Owedah [9 ]
Alalawi, Mohammed Ibrahim [10 ]
Alghamdi, Saleh [11 ]
Imam, Mohammad Tarique [12 ]
Almarzoky Abuhussain, Safa S. [13 ]
Khayyat, Sarah M. [13 ]
Haseeb, Abdul [13 ]
机构
[1] Bahauddin Zakariya Univ, Fac Pharm, Dept Pharm Practice, Multan, Pakistan
[2] Nishter Med Univ & Hosp, Multan, Pakistan
[3] Univ Educ Lahore, Dept Zool, Div Sci & Technol, Lahore, Pakistan
[4] Bahauddin Zakariya Univ, Fac Pharm, Dept Pharmaceut Chem, Multan, Pakistan
[5] Dow Univ Hlth Sci, Fac Pharmaceut Sci, Dept Pharm Practice, Karachi, Pakistan
[6] Univ Vet & Anim Sci, Inst Pharmaceut Sci, Lahore, Pakistan
[7] Univ Sains Malaysia, Sch Pharmaceut Sci, George Town, Malaysia
[8] Minist Hlth, Dept Pharm, King Abdullah Med City, Mecca, Saudi Arabia
[9] Minist Natl Guard Hlth Affairs, Pharmaceut Care Dept, King Abdulaziz Med City, Jeddah, Saudi Arabia
[10] Alnoor Specialist Hosp, Dept Internal Med, Mecca, Saudi Arabia
[11] Al Baha Univ, Fac Clin Pharm, Dept Clin Pharm, Al Baha, Saudi Arabia
[12] Prince Sattam Bin Abdulaziz Univ, Coll Pharm, Dept Clin Pharm, Al Kharj, Saudi Arabia
[13] Umm Al Qura Univ, Coll Pharm, Clin Pharm Dept, Mecca, Saudi Arabia
关键词
tuberculosis; diabetes mellitus; TB-DM comorbidity; multi-drug resistant TB; treatment failure; disease progression; PULMONARY TUBERCULOSIS; RISK-FACTORS; TREATMENT RESPONSE; DRUG-RESISTANCE; PREVALENCE; POPULATION;
D O I
10.3389/fpubh.2023.1244450
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background: The existence of Type 2 Diabetes Mellitus (DM) in tuberculosis (TB) patients is very dangerous for the health of patients. One of the major concerns is the emergence of MDR-TB in such patients. It is suspected that the development of MDR-TB further worsens the treatment outcomes of TB such as treatment failure and thus, causes disease progression.Aim: To investigate the impact of DM on the Emergence of MDR-TB and Treatment Failure in TB-DM comorbid patients.Methodology: The PubMed database was systematically searched until April 03, 2022 (date last searched). Thirty studies met the inclusion criteria and were included in this study after a proper selection process.Results: Tuberculosis-Diabetes Mellitus patients were at higher risk to develop MDR-TB as compared to TB-non-DM patients (HR 0.81, 95% CI: 0.60-0.96, p < 0.001). Heterogeneity observed among included studies was moderate (I2 = 38%). No significant change was observed in the results after sub-group analysis by study design (HR 0.81, 95% CI: 0.61-0.96, p < 0.000). In the case of treatment failure, TB-DM patients were at higher risk to experience treatment failure rates as compared to TB-non-DM patients (HR 0.46, 95% CI: 0.27-0.67, p < 0.001).Conclusion: The results showed that DM had a significant impact on the emergence of MDR-TB in TB-diabetes comorbid patients as compared to TB-non-DM patients. DM enhanced the risk of TB treatment failure rates in TB-diabetes patients as compared to TB-non-DM patients. Our study highlights the need for earlier screening of MDR-TB, thorough MDR-TB monitoring, and designing proper and effective treatment strategies to prevent disease progression.
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页数:11
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