TY - JOUR T1 - Diabetes Is a Risk Factor for Pulmonary Tuberculosis: A Case-Control Study from Mwanza, Tanzania A1 - Faurholt-Jepsen, Daniel A1 - Range, Nyagosya A1 - PrayGod, George A1 - Jeremiah, Kidola A1 - Faurholt-Jepsen, Maria A1 - Aabye, Martine Grosos A1 - Changalucha, John A1 - Christensen, Dirk Lund A1 - Pipper, Christian Bressen A1 - Krarup, Henrik A1 - Witte, Daniel Rinse A1 - Andersen, Aase Bengaard A1 - Friis, Henrik Y1 - 2011/08/30 N2 - Background Diabetes and TB are associated, and diabetes is increasingly common in low-income countries where tuberculosis (TB) is highly endemic. However, the role of diabetes for TB has not been assessed in populations where HIV is prevalent. Methods A case-control study was conducted in an urban population in Tanzania among culture-confirmed pulmonary TB patients and non-TB neighbourhood controls. Participants were tested for diabetes according to WHO guidelines and serum concentrations of acute phase reactants were measured. The association between diabetes and TB, and the role of HIV as an effect modifier, were examined using logistic regression. Since blood glucose levels increase during the acute phase response, we adjusted for elevated serum acute phase reactants. Results Among 803 cases and 350 controls the mean (SD) age was 34.8 (11.9) and 33.8 (12.0) years, and the prevalence of diabetes was 16.7% (95% CI: 14.2; 19.4) and 9.4% (6.6; 13.0), respectively. Diabetes was associated with TB (OR 2.2, 95% CI: 1.5; 3.4, p<0.001). However, the association depended on HIV status (interaction, p = 0.01) due to a stronger association among HIV uninfected (OR 4.2, 95% CI: 1.5; 11.6, p = 0.01) compared to HIV infected (OR 0.1, 95% CI: 0.01; 1.8, p = 0.13) after adjusting for age, sex, demographic factors and elevated serum acute phase reactants. Conclusion Diabetes is a risk factor for TB in HIV uninfected, whereas the association in HIV infected patients needs further study. The increasing diabetes prevalence may be a threat to TB control. JF - PLOS ONE JA - PLOS ONE VL - 6 IS - 8 UR - https://doi.org/10.1371/journal.pone.0024215 SP - e24215 EP - PB - Public Library of Science M3 - doi:10.1371/journal.pone.0024215 ER -