Non-communicable diseases increased risk of recurrent tuberculosis in epidemic area of Human Immunodeficiency Virus infection, Thailand

In recent decades, many countries in Southeast Asia such as Thailand reported an increase of non-communicable diseases (NCDs) and are faced with double burden of NCDs and communicable diseases such as tuberculosis. Recurrent tuberculosis (TB) has been reported in association with Human Immunodeficiency Virus infection (HIV) and diabetes mellitus, however the association between recurrent TB and other NCDs has not been well investigated in this region. A retrospective cohort study was conducted to determine risk of recurrent TB associated with NCDs in an endemic area of HIV in Thailand. Of 1,444 pulmonary TB patients who are registered and had completed a course of treatment during 2003-2012, 99 were diagnosed for recurrent TB (1.954 per 100 TB cases-year). After adjusting for HIV, age, sex, and previous TB treatment outcome, Poisson regression revealed significant risk of recurrent TB among patient with diabetes mellitus (RR=2.76; 95% CI=1.66-4.59), with chronic obstructive pulmonary disease (RR=2.16; 95% CI=1.33-3.49) and with liver cirrhosis (RR=4.45; 95% CI=2.23-8.87). Regular routine screening for TB among patients with liver cirrhosis, diabetes mellitus and chronic obstructive pulmonary disease should be established to improve prevention and control of TB in endemic areas of TB and HIV.