Prevelance of tuberculosis among children with type -1 diabetes mellitus attending El-Minia university hospital

ABSTRACT

Tuberculosis [TB] has been a cause of significant morbidity and mortality for mankind throughout history. Currently, there are tweenty million cases of TB worldwide with eight million new cases each year. Three million deaths annually are directly attributable to tuberculosis. Previous clinic-based studies in developed countries demonstrated an association between tuberculosis and diabetes but did not determine whether this is due to an increase in recently transmitted or reactivated infection of tuberculosis. We aim in this study to identify the epidemiological relationship between TB and diabetes in children by using a simple, rapid and reliable test which is MycoDot test. This study was a cross sectional study done on two groups, the first group was one hundred and ten cases of type -1 diabetic children aged from 5-10 years old who had a regular follow up in pediatric diabetes Mellitus out-patient clinic in El-Minya university hospital. The second group consisted of one hundred and ten children [as a control non-diabetic group] age and sex matched from pediatric out-patient clinic in El-Minya university hospital. The children were subjected to tuberculin skin test and Zeihl Nelseen staining on sputum. The diabetic children only were subjected to chest X -ray. The children's sera were subjected to MycoDot test. Among the one hundred and ten diabetic children, six cases [5.5%] assigned positive TB using MycoDot technique. On the other side the control cases assigned only one positive case [0.9%] using the same test. Among the diabetic children [110], four cases [3.8%] were found positive by Tuberculin skin test, whereas two cases [1.8%] were positive by Zeihl Nelseen staining on sputum. Many studies have explored the association between diabetes and tuberculosis. In developed countries, studies dating to the first half of the past century demonstrated considerable increase in the frequency of tuberculosis among patients with diabetes, although the proportion with comorbidity has ranged widely forn 1.0 to 9.3%. Other studies have shown a higher frequency of diabetes among individuals with tuberculosis. In our results, 5.5% of diabetic children suffered from active TB by MycoDot test which is a simple and reliable test, whereas only one positive case [0.9%] was found in the non-diabetic group by the same test. The formal indicates that risk of TB increases among diabetic children and this will give as an alarm to have regular searching for the presence of active TB among diabetic children