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Children with type 1 diabetes at increased risk for tuberculosis in endemic areas

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Researchers reported a high prevalence of tuberculosis in children and adolescents with type 1 diabetes in South Africa and, therefore, recommend routine screening in areas that are highly endemic for the disease.

The cross-sectional, hospital-based study included 258 children and adolescents with type 1 diabetes (58% girls). Each patient underwent a Mantoux tuberculin skin test, chest radiograph and HbA1c measurement.

The overall prevalence of tuberculosis was about 30%; nine participants were diagnosed with prevalent tuberculosis.

Prevalent tuberculosis was associated with poor glycemic control (HR=1.39; 95% CI, 24.2-35.4) and contact with a tuberculosis case.

The prevalence of tuberculosis increased from 7.8% at five years to 12.5% at 10 years after diagnosis of type 1 diabetes. The observed prevalence of tuberculosis among children and adolescents with type 1 diabetes was 6.8 times greater than the prevalence in the general population.

“Preventive treatment should be considered for diabetic children with proof of tuberculosis exposure and/or infection,” the researchers concluded.

Webb EA. Int J Tuberc Lung Dis. 2009;13:868-874.