AUTHOR=Rehman Anees ur , Khattak Mahnoor , Mushtaq Usman , Latif Muhammad , Ahmad Imran , Rasool Muhammad Fawad , Shakeel Sadia , Hayat Khezar , Hussain Rabia , Alhazmi Ghaidaa Ali , Alshomrani Afnan Owedah , Alalawi Mohammed Ibrahim , Alghamdi Saleh , Imam Mohammad Tarique , Almarzoky Abuhussain Safa S. , Khayyat Sarah M. , Haseeb Abdul 

TITLE=The impact of diabetes mellitus on the emergence of multi-drug resistant tuberculosis and treatment failure in TB-diabetes comorbid patients: a systematic review and meta-analysis

JOURNAL=Frontiers in Public Health

VOLUME=11

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1244450

DOI=10.3389/fpubh.2023.1244450

ISSN=2296-2565

ABSTRACT=<sec id="sec1"><title>Background</title><p>The existence of Type 2 Diabetes Mellitus (DM) in tuberculosis (TB) patients is very dangerous for the health of patients. One of the major concerns is the emergence of MDR-TB in such patients. It is suspected that the development of MDR-TB further worsens the treatment outcomes of TB such as treatment failure and thus, causes disease progression.</p></sec><sec id="sec2"><title>Aim</title><p>To investigate the impact of DM on the Emergence of MDR-TB and Treatment Failure in TB-DM comorbid patients.</p></sec><sec id="sec3"><title>Methodology</title><p>The PubMed database was systematically searched until April 03, 2022 (date last searched). Thirty studies met the inclusion criteria and were included in this study after a proper selection process.</p></sec><sec id="sec4"><title>Results</title><p>Tuberculosis-Diabetes Mellitus patients were at higher risk to develop MDR-TB as compared to TB-non-DM patients (HR 0.81, 95% CI: 0.60–0.96, <italic>p</italic> &lt; 0.001). Heterogeneity observed among included studies was moderate (I<sup>2</sup> = 38%). No significant change was observed in the results after sub-group analysis by study design (HR 0.81, 95% CI: 0.61–0.96, <italic>p</italic> &lt; 0.000). In the case of treatment failure, TB-DM patients were at higher risk to experience treatment failure rates as compared to TB-non-DM patients (HR 0.46, 95% CI: 0.27–0.67, <italic>p</italic> &lt; 0.001).</p></sec><sec id="sec5"><title>Conclusion</title><p>The results showed that DM had a significant impact on the emergence of MDR-TB in TB-diabetes comorbid patients as compared to TB-non-DM patients. DM enhanced the risk of TB treatment failure rates in TB-diabetes patients as compared to TB-non-DM patients. Our study highlights the need for earlier screening of MDR-TB, thorough MDR-TB monitoring, and designing proper and effective treatment strategies to prevent disease progression.</p></sec>