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In response to Dr Jolobe, our understanding of the epidemiology of tuberculosis in South Asians in the UK is that extrapulmonary disease is more common in this group.1 South Asians are therefore not necessarily predisposed only to pulmonary tuberculosis and its recurrence but to tuberculosis in general. What is likely is that being immunocompromised in this population, arising potentially from vitamin D deficiency2 and type 2 diabetes,3 is the important risk factor for tuberculosis and its recurrence. We therefore agree that diabetes could be another reason why South Asians appear to be at greater risk than other groups for recurrence of tuberculosis, but not necessarily just pulmonary forms of the disease. Although we have discussed potential factors associated with recurrence,4 national surveillance does not collect information on diabetes precluding us from assessing its role.
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