ArticleBMC research notes2020
Functional adrenal insufficiency among tuberculosis-human immunodeficiency virus co-infected patients: a cross-sectional study in Uganda.
Article in BMC research notes, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Interplay Between Infectious Diseases and the Endocrine System: An Overview and Clinical Insights.Endocrinology, diabetes & metabolism · 2026Review
- Characteristics and outcomes of adult emergency ward patients with sepsis who received corticosteroids at the Mbarara Regional Referral Hospital in Uganda.Emergency medicine journal : EMJ · 2025Observational
- Post-Tuberculosis Adrenal Crisis in a Young Boy: A Case Report.Clinical case reports · 2025Article
- A narrative review of the pathophysiology of sepsis in sub-Saharan Africa: Exploring the potential for corticosteroid therapy.PLOS global public health · 2025Review
- Prevalence, Clinical Features, and Predictors of Adrenal Insufficiency in Adults With Tuberculosis or HIV: A Systematic Review and Meta-analysis.Open forum infectious diseases · 2024Article
- Disseminated tuberculosis associated with autoimmune haemolytic anaemia and adrenal deficiency: a rare association.BMJ case reports · 2022Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
Abstract
objectiveTuberculosis (TB) is the leading cause of adrenal insufficiency in resource-limited settings. The adrenal gland is the most commonly affected endocrine organ in TB infection. We assessed factors associated with functional adrenal insufficiency (FAI) among TB-HIV patients with and without drug-resistance in Uganda. Patients with drug-sensitive and drug-resistant TB were enrolled and examined for clinical signs and symptoms of FAI with an early morning serum cortisol level obtained. FAI was defined as early morning serum cortisol < 414 nmol//L. Associations with FAI were modeled using multivariable logistic regression.
resultsWe screened 311 TB patients and enrolled 272. Of these, 117 (43%) had drug-resistant TB. Median age was 32 years (IQR 18-66) and 66% were men. The proportion with FAI was 59.8%. Mean cortisol levels were lower in participants with drug-resistant than susceptible TB (317.4 versus 488.5 nmol/L; p < 0.001). In multivariable analyses, drug-resistant TB (aOR 4.61; 95% CI 2.3-9.1; p < 0.001), treatment duration > 1 month (aOR 2.86; 95% CI 1.4-5.5; p = 0.002) and abdominal pain (aOR 2.06; 95% CI 1.04-4.09; p = 0.038) were significantly associated with FAI. Early morning serum cortisol levels should be quantified in TB-HIV co-infected patients with drug-resistant TB.
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