Mahnoor Khattak, Anees Ur Rehman, Tuba Muqaddas, Rabia Hussain, Muhammad Fawad Rasool, Zikria Saleem, Mesfer Safar Almalki, Samar Adel Alturkistani, Shuruq Zuhair Firash, Oseid Mohammed Alzahrani, Ammar Abdulraheem Bahauddin, Safa Almarzooky Abuhussain, Muath Fahmi Najjar, Hossameldeen Mahmoud Ali Elsabaa, Abdul Haseeb
{"title":"肺结核（TB）合并糖尿病患者的治疗挑战：系统回顾与荟萃分析。","authors":"Mahnoor Khattak, Anees Ur Rehman, Tuba Muqaddas, Rabia Hussain, Muhammad Fawad Rasool, Zikria Saleem, Mesfer Safar Almalki, Samar Adel Alturkistani, Shuruq Zuhair Firash, Oseid Mohammed Alzahrani, Ammar Abdulraheem Bahauddin, Safa Almarzooky Abuhussain, Muath Fahmi Najjar, Hossameldeen Mahmoud Ali Elsabaa, Abdul Haseeb","doi":"10.1080/07853890.2024.2313683","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The Directly Observed Treatment-Short Course (DOTS) Programme was implemented by WHO and includes a combination of four anti-tuberculosis (TB) drugs (isoniazid, pyrazinamide, ethambutol and rifampicin) for a period of six months to eradicate the TB infection completely. Diabetes mellitus (DM) is recognized as one of a strong contributor of TB according to World Health Organization (WHO). The presence of diabetes mellitus type 2 (DM type 2) makes TB treatment complicated. Thus, the objective of the current meta-analysis was to identify and quantify the impact of type 2 DM on treatment outcomes of TB patients treated under the DOTS Programme.</p><p><strong>Methods: </strong>This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Through a systematic review of relevant literature, we focused on studies investigating treatment outcomes including extended treatment duration and recurrence for individuals with both TB and DM undergoing DOTS therapy. The extracted information included study designs, sample sizes, patient characteristics and reported treatment results.</p><p><strong>Results: </strong>In 44 studies from different parts of the world, the pooled HR for the impact of DM on extended treatment duration and reoccurrence were HR 0.72, 95% CI 0.56-0.83, <i>p</i> < .01 and HR 0.93, 95% CI 0.70-1.04, <i>p</i> = .08, respectively. The pooled HR for impact of DM on composite TB treatment outcomes was calculated as 0.76 (95% CI 0.60-0.87), <i>p</i> < .01 with an effect size of 41.18. The heterogeneity observed among the included studies was moderate (<i>I</i><sup>2</sup> = 55.79%).</p><p><strong>Conclusions: </strong>A negative impact of DM was found on recurrence and extended treatment duration in TB patients treated with DOTS therapy. DM type 2 is responsible for the TB treatment prolongation and TB recurrence rates. By implementing effective management strategies and advancing research, the challenges can be mitigated, arising due to the complex interaction between DM and TB.</p>","PeriodicalId":93874,"journal":{"name":"Annals of medicine","volume":"56 1","pages":"2313683"},"PeriodicalIF":0.0000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863515/pdf/","citationCount":"0","resultStr":"{\"title\":\"Tuberculosis (TB) treatment challenges in TB-diabetes comorbid patients: a systematic review and meta-analysis.\",\"authors\":\"Mahnoor Khattak, Anees Ur Rehman, Tuba Muqaddas, Rabia Hussain, Muhammad Fawad Rasool, Zikria Saleem, Mesfer Safar Almalki, Samar Adel Alturkistani, Shuruq Zuhair Firash, Oseid Mohammed Alzahrani, Ammar Abdulraheem Bahauddin, Safa Almarzooky Abuhussain, Muath Fahmi Najjar, Hossameldeen Mahmoud Ali Elsabaa, Abdul Haseeb\",\"doi\":\"10.1080/07853890.2024.2313683\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The Directly Observed Treatment-Short Course (DOTS) Programme was implemented by WHO and includes a combination of four anti-tuberculosis (TB) drugs (isoniazid, pyrazinamide, ethambutol and rifampicin) for a period of six months to eradicate the TB infection completely. Diabetes mellitus (DM) is recognized as one of a strong contributor of TB according to World Health Organization (WHO). The presence of diabetes mellitus type 2 (DM type 2) makes TB treatment complicated. Thus, the objective of the current meta-analysis was to identify and quantify the impact of type 2 DM on treatment outcomes of TB patients treated under the DOTS Programme.</p><p><strong>Methods: </strong>This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Through a systematic review of relevant literature, we focused on studies investigating treatment outcomes including extended treatment duration and recurrence for individuals with both TB and DM undergoing DOTS therapy. The extracted information included study designs, sample sizes, patient characteristics and reported treatment results.</p><p><strong>Results: </strong>In 44 studies from different parts of the world, the pooled HR for the impact of DM on extended treatment duration and reoccurrence were HR 0.72, 95% CI 0.56-0.83, <i>p</i> < .01 and HR 0.93, 95% CI 0.70-1.04, <i>p</i> = .08, respectively. The pooled HR for impact of DM on composite TB treatment outcomes was calculated as 0.76 (95% CI 0.60-0.87), <i>p</i> < .01 with an effect size of 41.18. The heterogeneity observed among the included studies was moderate (<i>I</i><sup>2</sup> = 55.79%).</p><p><strong>Conclusions: </strong>A negative impact of DM was found on recurrence and extended treatment duration in TB patients treated with DOTS therapy. DM type 2 is responsible for the TB treatment prolongation and TB recurrence rates. By implementing effective management strategies and advancing research, the challenges can be mitigated, arising due to the complex interaction between DM and TB.</p>\",\"PeriodicalId\":93874,\"journal\":{\"name\":\"Annals of medicine\",\"volume\":\"56 1\",\"pages\":\"2313683\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10863515/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/07853890.2024.2313683\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/2/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/07853890.2024.2313683","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/2/12 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Tuberculosis (TB) treatment challenges in TB-diabetes comorbid patients: a systematic review and meta-analysis.
Background: The Directly Observed Treatment-Short Course (DOTS) Programme was implemented by WHO and includes a combination of four anti-tuberculosis (TB) drugs (isoniazid, pyrazinamide, ethambutol and rifampicin) for a period of six months to eradicate the TB infection completely. Diabetes mellitus (DM) is recognized as one of a strong contributor of TB according to World Health Organization (WHO). The presence of diabetes mellitus type 2 (DM type 2) makes TB treatment complicated. Thus, the objective of the current meta-analysis was to identify and quantify the impact of type 2 DM on treatment outcomes of TB patients treated under the DOTS Programme.
Methods: This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Through a systematic review of relevant literature, we focused on studies investigating treatment outcomes including extended treatment duration and recurrence for individuals with both TB and DM undergoing DOTS therapy. The extracted information included study designs, sample sizes, patient characteristics and reported treatment results.
Results: In 44 studies from different parts of the world, the pooled HR for the impact of DM on extended treatment duration and reoccurrence were HR 0.72, 95% CI 0.56-0.83, p < .01 and HR 0.93, 95% CI 0.70-1.04, p = .08, respectively. The pooled HR for impact of DM on composite TB treatment outcomes was calculated as 0.76 (95% CI 0.60-0.87), p < .01 with an effect size of 41.18. The heterogeneity observed among the included studies was moderate (I2 = 55.79%).
Conclusions: A negative impact of DM was found on recurrence and extended treatment duration in TB patients treated with DOTS therapy. DM type 2 is responsible for the TB treatment prolongation and TB recurrence rates. By implementing effective management strategies and advancing research, the challenges can be mitigated, arising due to the complex interaction between DM and TB.
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