Tuberculosis and Diabetes Bamako, Mali : prevalence, clinical and epidemiological features of the association

Abstract

Introduction and Methods: In Mali studies on Tuberculosis and Diabetis association are rare and partial. Because of the severity and complexity of its management, we undertake a retrospective study from January 1993 to December 2009 to estimate the prevalence of the association and to determine its epidemiological characteristics in Bamako, Mali. Results: Among the 2,110 diabetic cases notified at the different centers during the 17 years, 120 patients developed tuberculosis, with a prevalence of 5.7%. The sex ratio was 1.6. The age group 50-59 years old was the most represented with a mean age of 52.4 + / -13.5 years and extremes ranging from 7 to 83 years old. The prevalence of Human Immunodeficiency Virus (HIV) was 5%. Type 2 Diabetes was encountered in most patients up to 77.5%. Tuberculosis (TB) was at pulmonary location (PT) in 80 cases (66.7%), extrapulmonary (EPT) in 33 cases (27.5%), and 7 cases were disseminated to both places. The most widely means used for the diagnosis of TB was the combination of clinical, radiological, and therapeutic test for TB. At the end of treatment 84.2% of the patients presented complications related to diabetes, 17.5% related to TB, and 20% of deaths. Conclusion: TB and Diabetes association is not rare in Bamako, reaching up to 5.6%. The dual infection with HIV was present up to 5%, and this dual infection was completely lethal. The prognosis of TB and Diabetes association is poor with 20% death.