Year of Publication

2016

College

Public Health

Degree Name

Master of Public Health (M.P.H.)

Committee Chair

David Mannino, MD

Committee Member

April Young, PhD

Committee Member

Wayne T. Sanderson, PhD

Abstract

Rationale: Diabetes mellitus (DM) is recognized as a common comorbid condition for tuberculosis (TB). Those with comorbid conditions are more likely to develop active TB, to have trouble with treatment, and to have more severe symptoms.

Objective: To measure the prevalence and distribution of latent tuberculosis infection (LTBI) and DM control in the United State and test their association when measured by tuberculin skin test (TST) or QuantiFERON®-TB Gold In-Tube blood test (QFT-GIT) and by HbA1c, respectively. Literature Review: One-third of the world population is infected with TB. Ten percent of TB cases worldwide are linked to diabetes mellitus. Studies have found that the risk of TB increases with the presence of DM.

Methods: This is a cross-sectional, secondary analysis study of the 2011-2012 National Health and Nutrition Examination Survey. The study population included 4,222 participants. Frequency and proportions of each variable were calculated. Then calculations of the frequency and conditional distribution of LTBI for the predictors were made. The chi-square test of association was used to test relationship between LTBI and DM control. Finally, unadjusted and adjusted odds of LTBI were calculated using binary and multiple logistic regressions, respectively.

Main Results: The chi-square test of association found that LTBI and DM control are not independent. The unadjusted logistic regression showed significantly increased odds of having LTBI for those with HbA1c levels corresponding prediabetes and diabetes compared to those with normal HbA1c levels, which the adjusted logistic regression did not.

Conclusion: This study found that LTBI and DM control were associated. There was increased likelihood of having LTBI with poorer diabetes mellitus control, however, the increased odds disappeared when accounting for covariates.

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