Perbedaan Proporsi Sputum Bakteri Tahan Asam Positif pada Pasien Diabetes Melitus Terkendali dan Tidak Terkendali

Elga Citra Lylyanti Harahap, Angki Purwanti, Nova Hardianto

Abstract


Currently, when the prevalence of diabetes mellitus (DM) is high and predicted to continue to increase, the elimination of tuberculosis (TB) in Indonesia has not been successful. The challenge is greater due to the comorbidity of both diseases and the complexity of the relationship between the two that is not yet well understood. Therefore, studies on DM-TB comorbidity in various populations are still needed. This study aims to determine the difference in the proportion of positive acid-fast bacillus (AFB) sputum between groups of controlled DM patients (HbA1c <6.5%) and uncontrolled (HbA1c ≥6.5%). The design of this study is cross-sectional, using secondary data (medical records) of 126 DM patients at the Persahabatan Hospital, Jakarta, who underwent examinations in January-June 2024. The results showed that the proportion of positive AFB sputum in the uncontrolled DM patient group was 41.3 percent and in the controlled group was 11.1 percent (based on the Chi-Square test, p-value <0.0001). In addition, the uncontrolled DM patient group had a median (youngest-oldest) age of 55 (37-74) years, while the controlled DM group was 50 (32-70) years (based on the Mann-Whitney test, p-value 0.036). This study shows that the uncontrolled DM patient group had a higher proportion of positive BTA sputum and was significantly older than the controlled DM patient group.

Keywords


diabetes mellitus, HbA1c, tuberculosis, acid-fast bacteria

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References


Abbas, U., Masood, K. I., Khan, A., Irfan, M., Saifullah, N., Jamil, B., & Hasan, Z. (2022). Tuberculosis and diabetes mellitus: Relating immune impact of co-morbidity with challenges in disease management in high burden countries. Journal of Clinical Tuberculosis and Other Mycobacterial Diseases, 29(November), 100343. https://doi.org/10.1016/j.jctube.2022.100343

Abdissa, D., & Hirpa, D. (2022). Poor glycemic control and its associated factors among diabetes patients attending public hospitals in West Shewa Zone, Oromia, Ethiopia: An Institutional based cross-sectional study. Metabolism Open, 13(October 2021), 100154. https://doi.org/10.1016/j.metop.2021.100154

Al-Rifai, R. H., Pearson, F., Critchley, J. A., & Abu-Raddad, L. J. (2017). Association between diabetes mellitus and active tuberculosis: A systematic review and meta-analysis. PLOS ONE, 12(11), e0187967. Diambil dari https://doi.org/10.1371/journal.pone.0187967

Alavi, S. M., & Khoshkhoy, M. M. (2012). Pulmonary tuberculosis and diabetes mellitus: Co-existence of both diseases in patients admitted in a teaching hospital in the southwest of Iran. Caspian Journal of Internal Medicine, 3(2), 421–424.

Alawainati, M. A., Ayoob, Z. A., & Naser, H. S. (2023). Characteristics, glycemic control and outcomes of adults with type‑2 diabetes mellitus attending specialized clinics in primary healthcare centers in Bahrain—A cross‑sectional study. Journal of Family Medicine and Primary Care, 12, 2576–2583. https://doi.org/10.4103/jfmpc.jfmpc_829_23

Badan Kebijakan Pembangunan Kesehatan Kementerian Kesehatan. (2023). Survei Kesehatan Indonesia (SKI) 2023 Dalam Angka. Diambil dari https://layanandata.kemkes.go.id/katalog-data/ski/ketersediaan-data/ski-2023

Bates, M., Marais, B. J., & Zumla, A. (2015). Tuberculosis comorbidity with communicable and noncommunicable diseases. Cold Spring Harbor Perspectives in Medicine, 5(11), 1–15. https://doi.org/10.1101/cshperspect.a017889

Bisht, M. K., Dahiya, P., Ghosh, S., & Mukhopadhyay, S. (2023). The cause–effect relation of tuberculosis on incidence of diabetes mellitus. Frontiers in Cellular and Infection Microbiology, 13. https://doi.org/10.3389/fcimb.2023.1134036

Boadu, A. A., Yeboah-manu, M., Osei-wusu, S., & Yeboah-manu, D. (2024). International Journal of Infectious Diseases Tuberculosis and diabetes mellitus : The complexity of the comorbid interactions. International Journal of Infectious Diseases, 146, 107140. https://doi.org/10.1016/j.ijid.2024.107140

Buasroung, P., Petnak, T., Liwtanakitpipat, P., & Kiertiburanakul, S. (2022). Prevalence of Diabetes Mellitus in Patients with Tuberculosis: A Prospective Cohort Study. International Journal of Infectious Diseases, 116, 374–379. https://doi.org/10.1016/j.ijid.2022.01.047

Critchley, J. A., Carey, I. M., Harris, T., DeWilde, S., Hosking, F. J., & Cook, D. G. (2018). Glycemic control and risk of infections among people with type 1 or type 2 diabetes in a large primary care cohort study. Diabetes Care, 41(10), 2127–2135. https://doi.org/10.2337/dc18-0287

Dahlan, M. S. (2020). Statistik untuk kedokteran dan kesehatan; deskriptif, bivariat, dan multivariat dilengkapi aplikasi menggunakan SPSS (6 ed.). Jakarta: Epidemiologi Indonesia.

Ewid, M., Algoblan, A. S., Elzaki, E. M., Muqresh, M. A., Al Khalifa, A. R., Alshargabi, A. M., … Naguib, M. (2023). Factors associated with glycemic control and diabetes complications in a group of Saudi patients with type 2 diabetes. Medicine, 102(38). https://doi.org/10.1097/MD.0000000000035212

Fachri, M., Hatta, M., Abadi, S., Santoso, S. S., Wikanningtyas, T. A., Syarifuddin, A., … Noviyanthi, R. A. (2018). Comparison of acid fast bacilli (AFB) smear for Mycobacterium tuberculosis on adult pulmonary tuberculosis (TB) patients with type 2 diabetes mellitus (DM) and without type 2 DM. Respiratory Medicine Case Reports, 23(February), 158–162. https://doi.org/10.1016/j.rmcr.2018.02.008

Fekadu, G., Bula, K., Bayisa, G., Turi, E., Tolossa, T., & Kasaye, H. K. (2019). Challenges and factors associated with poor glycemic control among type 2 diabetes mellitus patients at nekemte referral hospital, Western Ethiopia. Journal of Multidisciplinary Healthcare, 12, 963–974. https://doi.org/10.2147/JMDH.S232691

Ghazali, M. V., Sastromihardjo, S., Soedjarwo, S. R., Soelaryo, T., & Pramulyo, H. S. (2014). Studi cross-sectional. In S. Sastroasmoro & S. Ismael (Ed.), Dasar-dasar Metodologi Penelitian Klinis (5 ed., hal. 131–144). Jakarta: Sagung Seto.

Ibrahim, A. O., Agboola, S. M., Elegbede, O. T., Ismail, W. O., Agbesanwa, T. A., & Omolayo, T. A. (2021). Glycemic control and its association with sociodemographics, comorbid conditions, and medication adherence among patients with type 2 diabetes in southwestern Nigeria. Journal of International Medical Research, 49(10), 03000605211044040. https://doi.org/10.1177/03000605211044040

International Diabetes Federation. (2021). IDF Diabetes Atlas (10th ed.). Diambil dari https://diabetesatlas.org/idfawp/resource-files/2021/07/IDF_Atlas_10th_Edition_2021.pdf

Isbaniah, F., Burhan, E., Sinaga, B. Y., Yanifitri, D. B., Handayani, D., Harsini, … Sugiri, Y. J. R. (2021). Tuberkulosis: Pedoman Diagnosis dan Penatalaksanaan di Indonesia (Revisi 2). Jakarta: Perhimpunan Dokter Paru Indonesia.

Madiyono, B., Moeslichan Mz, S., Sastroasmoro, S., Budiman, I., & Purwanto, S. H. (2014). Perkiraan besar sampel. In S. Sastroasmoro & S. Ismael (Ed.), Dasar-dasar Metodologi Penelitian Klinis (5 ed., hal. 352–386). Jakarta: Sagung Seto.

Mamo, Y., Bekele, F., Nigussie, T., & Zewudie, A. (2019). Determinants of poor glycemic control among adult patients with type 2 diabetes mellitus in Jimma University Medical Center, Jimma zone, south west Ethiopia: a case control study. BMC Endocrine Disorders, 19(1), 91. https://doi.org/10.1186/s12902-019-0421-0

Martinez, N., & Kornfeld, H. (2014). Diabetes and immunity to tuberculosis. European Journal of Immunology, 44(3), 617–626. https://doi.org/10.1002/eji.201344301

Ojo, O. A., Ibrahim, H. S., Rotimi, D. E., Ogunlakin, A. D., & Ojo, A. B. (2023). Diabetes mellitus: From molecular mechanism to pathophysiology and pharmacology. Medicine in Novel Technology and Devices, 19(February), 100247. https://doi.org/10.1016/j.medntd.2023.100247

Perkumpulan Endokrinologi Indonesia. (2021). Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 di Indonesia 2021. Diambil dari https://pbperkeni.or.id/wp-content/uploads/2021/11/22-10-21-Website-Pedoman-Pengelolaan-dan-Pencegahan-DMT2-Ebook.pdf

Puetri, N. R., Hadifah, Z., Nur, A., & Hanum, S. (2019). Comparison of HbA1c Levels in Patients With TB-DM And TB-non DM. Majalah Kedokteran Bandung, 51(3), 141–146. https://doi.org/10.15395/mkb.v51n3.1753

Putra, O. N., Hardiyono, H., Rizkiyah, F., & Yuniar N.H, A. (2020). Impact of Uncontrolled HbA1C on The Outcome of Tuberculosis Treatment in TB Patients With Diabetes. Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan, 14(2), 210–220. https://doi.org/10.33533/jpm.v14i2.2276

Restrepo, B. I. (2016). Diabetes and Tuberculosis. Microbiology Spectrum, 4(6). https://doi.org/10.1128/microbiolspec.tnmi7-0023-2016

Restrepo, B. I., Camerlin, A. J., Rahbar, M. H., Wang, W., Restrepo, M. A., Zarate, I., … Fisher-Hoch, S. P. (2011). Cross-sectional assessment reveals high diabetes prevalence among newly-diagnosed tuberculosis cases. Bulletin of the World Health Organization, 89(5), 352–359. https://doi.org/10.2471/BLT.10.085738

Schnell, O., Crocker, J. B., & Weng, J. (2017). Impact of HbA1c Testing at Point of Care on Diabetes Management. Journal of Diabetes Science and Technology, 11(3), 611– 617. https://doi.org/10.1177/1932296816678263

Seifert, M., Aung, H. T., Besler, N., Harris, V., Mar, T. T., Colman, R. E., … Aung, S. T. (2021). Age and sex distribution of Mycobacterium tuberculosis infection and rifampicin resistance in Myanmar as detected by Xpert MTB/RIF. BMC Infectious Diseases, 21(1), 781. https://doi.org/10.1186/s12879-021-06296-0

Shamshirgaran, S. M., Mamaghanian, A., Aliasgarzadeh, A., Aiminisani, N., Iranparvar-Alamdari, M., & Ataie, J. (2017). Age differences in diabetes-related complications and glycemic control. BMC Endocrine Disorders, 17(1), 25. https://doi.org/10.1186/s12902-017-0175-5

Workneh, M. H., Bjune, G. A., & Yimer, S. A. (2017). Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review. PLoS ONE, 1–25. https://doi.org/10.1371/journal.pone.0175925

World Health Organization. (2023). Global tuberculosis report 2023. Diambil dari https://iris.who.int/bitstream/handle/10665/373828/9789240083851-eng.pdf?sequence=1

Wu, Q., Liu, Y., Ma, Y.-B., Liu, K., & Chen, S.-H. (2022). Incidence and prevalence of pulmonary tuberculosis among patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Annals of Medicine, 54(1), 1657–1666. https://doi.org/10.1080/07853890.2022.2085318

Yoo, J. E., Kim, D., Han, K., Rhee, S. Y., Shin, D. W., & Lee, H. (2021). Diabetes Status and Association With Risk of Tuberculosis Among Korean Adults. JAMA Network Open, 4(9). https://doi.org/10.1001/jamanetworkopen.2021.26099

Zaini, B. S. I., Donasrtin, A., Shanty, L. M., & Salim, H. M. (2020). Comparison The Value Of BTA Sputum Between Pulmonary Tuberculosis Patients With Diabetes Mellitus and Pulmonary Tuberculosis Patients Non-Diabetes Mellitus. Jurnal Kesehatan Islam : Islamic Health Journal, 9(2), 43–48. https://doi.org/10.33474/jki.v9i2.8869




DOI: https://doi.org/10.30602/jlk.v8i1.1590

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