3. Prevalence of Asymptomatic Pulmonary Tuberculosis in Diabetics Patients in District Bannu and Adjacent Areas
Tahirullah, Raza Muhammad Khan and Nafidullah Khan
ABSTRACT
Objective: This study aimed to determine the Prevalence of Asymptomatic Pulmonary Tuberculosis in Diabetic patients in District Bannu and adjacent areas.
Study Design: Descriptive, case series study.
Place and Duration of Study: This study was conducted at the DHQ Teaching Hospital (DHDTH) in Bannu, Khyber Pakhtunkhwa from January 2022 to July 2022.
Methods: Data were collected from 100 patients who had Diabetes (either Type 1 or 2) for 5 or more years, presented to medical OPD or admitted in Medical Ward, with no respiratory symptoms, but having only mild undiagnosed fever for more than 2 weeks.
Results: Out of 100 patients, 41 were males (41%) and 59 (59%) were females. All of these were having Diabetes (19 having Type 1 and 81 Type 2) for 5 or more years. They had mild fever for more than 2 weeks, which was not yet diagnosed. None of them were having respiratory symptoms like cough, sputum, pleuretic chest pain, hemoptysis or noisy chest. Out of these, all 100 patients (100%) were having uncontrolled Diabetes (RBS>200mg/dl, FBS>126mg/dl, HbA1C% >7.5%) and mild Fever (>100.0F) for >2weeks.
They all were advised chest x-ray for screening of pulmonary tuberculosis, 23 came out to have pulmonary tuberculosis, based on radiological diagnosis. Later on, the same were confirmed either bacteriologically or through HRCT (High Resolution CT thorax).
Conclusion: In our set up, Tuberculosis (both pulmonary and extra/pulmonary) is chronic and endemic, having a diverse clinical presentations. In diabetic patients, it is even more common, and asymptomatic with no respiratory symptoms having only mild undiagnosed fever for more than 2 weeks , and remains undiagnosed on routine examination. Thus, all diabetic patients must have a screening chest X-ray, when they have prolong fever for >2weeks, even though they do not have any respiratory symptoms. For early diagnosis and treatment to reduce the illness burden, infectivity, transmission, and consequences, a physician must maintain high suspicion and alertness.
Key Words: Asymptomatic Pulmonary tuberculosis, Diabetes Mellites, District Bannu.