Proportion of Rifampicin Resistance in Sputum Smear Positive Pulmonary Tuberculosis with Diabetes Mellitus in Urban Bengaluru - A Cross-Sectional Study

Author(s): Srinivasa Kaligonahalli Venkataramanappa1, Jeevan Basavaraj2

Pulmonary tuberculosis (PTB) still remains a global public health problem. Diabetes
along with poor glycaemic control leads to an immune compromised state. Type 2
diabetes (DM) is a strong risk factor for tuberculosis (TB) and is associated with a
slower response to TB treatment and a higher mortality rate. Objective of the
study was to determine the prevalence of rifampicin resistance in pulmonary
tuberculosis in patients with DM.
The study was conducted in General Medicine Department, Dr. B.R. Ambedkar
Medical College, Bengaluru, Karnataka, from July 2018 to December 2019. Sputum
was collected from a total of 100 patients who were sputum smear positive for
acid fast bacilli (AFB). Sample was collected and was subjected to GeneXpert
testing for the evaluation of resistance against rifampicin.
In our study the incidence of rifampicin resistance was 45.16 % in diabetes and
5.79 % in non-diabetes which was statistically significant (?2-1.1; p-0.01) between
rifampicin resistance and diabetic patients’ status with active TB in South
Karnataka, India. This result supports previous research showing a higher
multidrug-resistant tuberculosis risk in tuberculosis & diabetes patients relative to
those with no diabetes. Additionally, correlation of other findings between type 2
diabetes & multidrug-resistant tuberculosis as well as delayed time to sputum
smear conversion were confirmed.
The results showed correlation between diabetes & rifampicin resistance and
probably suggest the necessity of integrated diabetes and tuberculosis surveillance
programs in South Karnataka, India.