Risk for Severe Pulmonary Tuberculosis among Alcoholics and Diabetics

Abstract

Tuberculosis is a major public health problem. Some patients present with minimal lesions where as others present with advanced lesions. Patients with advanced or severe disease have high morbidity and mortality. Their infectiousness is also high. This is a Case control study to identify the strength of associations between two important factors, namely alcoholism and diabetes mellitus, and severity of disease. There were 80 cases and 80 controls. Cases were patients with severe disease and controls were patients with minimal disease. Severity of tuberculosis was assessed by chest radiographic criteria as per American Thoracic Society recommendation. The study was done over a period of 18 months. Both inclusion and exclusion criteria were applied in the selection of cases and controls. 46.25% of cases and 23.75% of controls were alcoholic. 15% of cases were suffering from diabetes mellitus whereas only 5% of controls were diabetic. Univariate analysis showed that both alcoholism and diabetes mellitus were significant risk factors. When the confounding effect of age was also taken into account, diabetes mellitus was not found to be a significant risk factor in causing severe pulmonary tuberculosis. Therefore preventive measures may be targeted to alcoholics for the early identification of severe pulmonary tuberculosis.