Abstract
BackgroundThe prevalence of diabetes mellitus (DM) is increasing globally and its comorbidity with tuberculosis (TB) is re-emerging, especially in low- and middle-income countries.ObjectiveThe main aim of this study is to determine the prevalence of DM and HIV infection and their associated risk factors among active tuberculosis patients in Northwest Ethiopia.MethodsThis hospital-based cross-sectional study was conducted between February 1st and June 30th, 2017 among active TB patients in two hospitals of Northwest Ethiopia. Two hundred and sixty-seven active TB cases aged 18 years or older were screened for diabetes using fasting blood glucose (FBG) test. Semi-structured questionnaires were used to collect demographic data, lifestyle habits and clinical data. Identification of pre-diabetes or diabetes in TB patients was achieved according to American Diabetes Association guidelines (2016).ResultsPrevalence of DM and TB comorbidity was 11.5% (95% confidence interval, CI 7.8–15.2) compared to 24.9% (95% CI 20.1–30.1) for pre-diabetes. Prevalence of HIV/TB co-infection was 21.9% (95% CI 16.7–26.8). Risk of DM was higher in TB patients from a rural location (adjusted odds ratio, aOR 3.13, 95% CI 1.02–9.62, p = 0.046). Similarly, DM was higher in TB patients who have a family history of DM (aOR 4.54, 95% CI 1.31–15.68, p = 0.017). Furthermore, HIV/TB co-infection was identified as a predictor of DM comorbidity in active TB patients (aOR 5.11, 95% CI 2.01–12.98, p = 0.001).ConclusionThe magnitude of DM and pre-diabetes in active TB patients in Northwest Ethiopia was high, warranting collaborative efforts to improve screening and adopt better clinical management strategies for DM–TB comorbid patients. Furthermore, being rural residents, family history of DM and HIV/TB co-infection were found to associate with DM among TB patients, highlighting the importance of the above-mentioned risk factors in the clinical management of this comorbidity.
Highlights
Diabetes mellitus (DM) is a chronic non-communicable disease which impacts the lives and wellbeing of our global population: the prevalence of diabetes mellitus (DM) in 2019 wasTulu et al Trop Med Health (2021) 49:68 estimated to be 9.3% (463 million people), which is predicted to rise to 10.2% (578 million) by 2030 and 10.9% (700 million) by 2045 [1]
Being rural residents, family history of DM and human immunodeficiency virus (HIV)/TB co-infection were found to associate with DM among TB patients, highlighting the importance of the above-mentioned risk factors in the clinical management of this comorbidity
Prevalence of DM and HIV among active TB patients Based on the fasting plasma glucose (FPG) analysis, prevalence of DM comorbidity (FPG ≥ 126 mg/dL) and impaired fasting glucose (FPG = 100–125 mg/dL) among active TB patients was 11.5% (31/269) and 24.9% (67/269), respectively
Summary
Diabetes mellitus (DM) is a chronic non-communicable disease which impacts the lives and wellbeing of our global population: the prevalence of DM in 2019 wasTulu et al Trop Med Health (2021) 49:68 estimated to be 9.3% (463 million people), which is predicted to rise to 10.2% (578 million) by 2030 and 10.9% (700 million) by 2045 [1]. In 2018, an estimated 10 million people fell ill with TB, resulting in close to 1.2 million deaths among human immunodeficiency virus (HIV) negative individuals and 251,000 deaths among HIV-positive cases [2]. The biological association of TB and DM is not fully understood, studies suggest that diabetes depresses immune responses, which in turn facilitates infection with Mycobacterium tuberculosis (M. tuberculosis) and/or progression to symptomatic disease. This is corroborated by the fact that diabetes is generally diagnosed before TB develops [5, 6]. The prevalence of diabetes mellitus (DM) is increasing globally and its comorbidity with tuberculosis (TB) is re-emerging, especially in low- and middle-income countries
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
