Tuberculosis in Jakarta

Based on medical records of patients diagnosed with diabetes mellitus (DM) and receiving healthcare services at RSUP Persahabatan Jakarta from January to June 2024, a study included 126 patients, with 63 classified as having controlled DM and 63 as having uncontrolled DM. The proportion of male patients (51.59%) was slightly higher than that of female patients (48.41%). The patients’ ages ranged from 32 to 74 years. HbA1c levels varied between 5% and 12%. Sputum examination for acid-fast bacilli (AFB) was positive in 26.19% of the subjects. The proportion of AFB-positive results was significantly higher in the uncontrolled DM group (41.3%) compared to the controlled DM group (11.1%).[1]

A retrospective observational analytical study analyzed medical record data from 2019 to 2021 at Persahabatan General Hospital, Jakarta, involving 82 patients. Of the total subjects, 45 (54.9%) underwent examination using the Xpert MTB/RIF method. Glycemic control assessments revealed that 65 subjects (79.3%) had an HbA1c level >7%, 59 subjects (72%) had a fasting plasma glucose (FPG) level >130 mg/dL, and 66 subjects (80.5%) had a 2-hour postprandial blood glucose level >180 mg/dL, indicating generally poor glycemic control.[2]

Regarding TB treatment duration in patients with comorbid type 2 diabetes mellitus (T2DM), the majority (57 subjects, 69.5%) received treatment for 9 months, while 11 subjects (13.4%) underwent 12 months of treatment, and 14 subjects (17.1%) followed the standard 6-month regimen. A total of 33 subjects (40.2%) received a combination of oral antidiabetic drugs (OAD) and insulin injections.[2] 

Among the 17 subjects with optimal glycemic control, 8 (47.1%) completed pulmonary TB treatment within 6 months, while 9 (52.9%) required a longer duration. Conversely, among the 65 subjects with non-optimal glycemic control, 59 (90.8%) required TB treatment beyond 6 months, while only 6 (9.2%) completed treatment within the standard timeframe. The analysis yielded an Odds Ratio (OR) of 8.741 (95% CI: 2.45–31.11), indicating that non-optimal glycemic control increased the likelihood of requiring extended TB treatment by 8.741 times compared to patients with optimal glycemic control.[2]

References:

1. Harahap, E.C.L., Purwanti, A. and Hardianto, N., 2024. Perbedaan Proporsi Sputum Bakteri Tahan Asam Positif pada Pasien Diabetes Melitus Terkendali dan Tidak Terkendali. Jurnal Laboratorium Khatulistiwa, 8(1), pp.168-180.

2. Widihastuti, A., Sirait, R.H., Simatupang, A. and Idhayu, A.T., 2023. Effect of Poor Glycemic Control with Length of Pulmonary Tuberculosis Treatment in Type 2 Diabetes Mellitus Patients. Jurnal Farmasi Klinik Indonesia, 12(1), pp.1-10.