Tuberculose e Diabetes Mellitus: análise de casos em hospital de referência.

Abstract

The association between diabetes mellitus (DM) and tuberculosis (TB) has become re-emergent with diabetes type 2 outbreak and the double load TB-DM represents nowadays a severe world public health problem. The incidence of TB tends to stabilize or to drop down in the next decades. However, due to a growing prevalence of DM, the relative contribution of the diabetics to the TB outbreak will increase. Objectives: To evaluate the demographics, clinical and diagnoses differences in patients with TB, with or without DM, and the association to comorbidities like HIV, AIDS, and ingestion of alcohol. Methods: It is an ecological study, analytical descriptive, based in a research with secondary data from the Sistema de Informação de Agravos de Notificação (SINAN), of the tuberculosis and diabetes mellitus cases diagnosed and followed in the Clementino Fraga Hospital in João Pessoa – PB, between the years of 2004 and 2014. The final sampling was composed by 3831 patients with TB, among these 314 had TB-DM. For the analysis of association was used the qui-square test, using significance level of 5% (p < 0.05), being calculated the odds ratio (OR) and the trustable gap (IC) of 95%. Results: Individuals with TB-DM were older than the TB without DM (average age 53.45 versus 38.06 years old); with predominance of the brown race 76.43% (n = 240); 91.7% (n = 287) presented the pulmonary type of TB. (OR 2.08 IC 1.378-3.14 p < 0.001). Between the extrapulmonary types, pleural TB with 37% (n = 10) in the TB-DM group. There was not association with the results of the tuberculin tests (p = 0.423), chest X-ray (p = 0.21) and the ingestion of alcohol (p = 0.377). The HIV didn´t increase the chance of DM in patients with TB (OR 0.319 IC 0.188-0.542 p < 0.001. Conclusion: This study emphasizes the importance of the knowledge of DM in patients with TB and the need of adding strategies of screening of the DM to the control programs of the tuberculosis.