Glycated haemoglobin (HbA1c) as a reliable option for detecting diabetes among the urban poor population in Bangladesh.

Our previous epidemiological survey targeting urban slum dwellers in Bangladesh showed that the prevalence of diabetes defined by glycated haemoglobin (HbA1c) was higher than the national estimation, and higher in women than men. Subsequently, we conducted the oral glucose tolerance test (OGTT) and found that HbA1c values were consistent with the OGTT findings for detecting diabetes. Our findings indicated that HbA1c ≥6.5% was a rational cut-off, but the optimal HbA1c cut-off for this population might be lower than the internationally recommended threshold. Measuring HbA1c would be a reliable and feasible option for detecting diabetes among underprivileged population in developing countries.

Serum zinc level and its association with multidrug-resistant tuberculosis.

Background: Zinc deficiency is evident in chronic diseases, but little is known about its association with multi-drug resistant tuberculosis (MDRTB). We aimed to measure serum zinc level in MDRTB patients and explore its association with MDRTB compared to drug-sensitive tuberculosis (DSTB). Methods: We recruited 107 MDRTB and 87 DSTB patients from a tuberculosis referral hospital in Bangladesh. After overnight fasting, 5 ml venous blood was collected from each patient to measure serum zinc level through graphite furnace atomic absorption spectrophotometry method. Multivariate logistic regression was done to measure its association with MDRTB. Results: The mean age of all patients was 36 years, where 70% were male. About 27% MDRTB patients and 2.3% DSTB patients had low serum zinc level (P < 0.0001). An inverse correlation was observed between serum zinc level and duration of anti-TB therapy (r-value: -0.252, P < 0.01). Reduced serum zinc level (odds ratio, 0.957; 95% confidence interval 0.923-0.992) was found as a significant associating factor for MDRTB after adjusted with age, sex, occupation, residence, tobacco consumption, Bacillus Calmette-Guérin-vaccination, and duration of anti-TB therapy. Conclusion: A lower serum zinc level is significantly associated with MDRTB. The tuberculosis control program should address this in the MDRTB control strategy.