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Background: A significant link between diabetes mellitus (DM) and tuberculosis (TB) has been widely demonstrated. DM increases the risk of TB in all aspects. The aims of this study were to assess the prevalence of DM among newly diagnosed TB patients, to screen these patients for DM, and to determine the number needed to screen (NNS) to diagnose new cases of DM. Methods: A prospective cohort descriptive study was carried out in Iranian adults admitted to the National Research Institute of Tuberculosis and Lung Disease from 2012 to 2013 with a new diagnosis of TB. Glycated hemoglobin (HbA1c) and fasting blood glucose (FBG) were measured for all patients. Results: Of the 293 patients included, 101 (34.5%) had DM. DM was newly diagnosed in 45 (19%) patients. The number needed to screen was 5 to identify one new DM case. Age = 40 years was associated with DM in this population (odds ratio (OR) = 3.91, 95% confidence interval (CI) = 1.47-10.38). Conclusion: Screening for DM should be performed routinely in patients with TB and may improve treatment outcomes. [ABSTRACT FROM AUTHOR]

Background: The early definitive diagnosis of pulmonary tuberculosis (TB) is important for control of the disease in the community. We performed this study to evaluate the additional gain of post-bronchoscopy sputum in the diagnosis of pulmonary TB. Methods: Bronchoscopy and bronchoalveolar lavage were performed for 126 patients suspected of pulmonary TB who either had 3 negative sputum smears for acid-fast bacilli or could not expectorate. After bronchoscopy the patients were asked to give sputum samples for 3 consecutive days. All of the obtained specimens were investigated for Mycobacterium tuberculosis by smear and culture. Results: Pulmonary TB was confirmed in 56 patients. Among all confirmed cases, the sensitivity of bronchoalveolar lavage smear was 57.1% (32 of 56), sensitivity of post-bronchoscopy smear was 76.7% (43 of 56), and the yield of a combination of the 2 methods was 83.9% (47 of 56). Results of post-bronchoscopy sputum smears were not significantly related to sex, age, human immunodeficiency virus (HIV) infection, presence of cavitary lesions on chest X-ray, or the ability to expectorate before bronchoscopy ( p > 0.05). Conclusion: Evaluation of post-bronchoscopy sputum smears is helpful for earlier diagnosis of pulmonary TB and is an inexpensive and accessible assay. [ABSTRACT FROM AUTHOR]

The clinical relevance of second-line drug susceptibility test (DST) results with respect to treatment outcome is unknown in non-XDR MDR patients. This study was carried out in the sole national referral centre for TB in Iran between 2002 and 2006. Multidrug-resistant tuberculosis (MDR-TB) patients who had DST to second-line drugs were included. For all MDR-TB patients the standard second-line regimen was initiated. Outcome of treatment based on DST to second-line drugs was analysed. 53 patients were included. DST for second-line drugs was available for 40 patients. Seven patients returned to Afghanistan during treatment. Among the remainder, 13 (30.4%) cases were Iranian. Mean age was 40.8 + 19.7 y. The relatively small sample size imposes some limitations on this study. However, in this study, there was no difference in resistance to second-line drugs by nationality. No significant correlation was seen between resistance to second-line drugs and outcome of treatment. In conclusion, the treatment outcome according to WHO definitions was appropriate in the study population by the use of standardized treatment regimens. Follow-up studies on a long-term basis are however needed in order to detect possible relapses. [ABSTRACT FROM AUTHOR]