Abstract

The burden of both tuberculosis (TB) and diabetes mellitus in developing countries including Ghana is high; often, the two coexist and impact each other negatively. Objective. The study aimed to determine the prevalence and predictive factors of dysglycaemia among newly diagnosed smear positive tuberculosis patients at a tertiary tuberculosis treatment centre in Ghana. Methods. Dysglycaemia at diagnosis was determined by the use of oral glucose tolerance test (OGTT), while sputum smear microscopy was used to assess the sputum status. Only smear positive patients were included in the study. Information on sociodemographic, anthropometrical, clinical, and medication history was also obtained. Results. In all, 146 participants, aged 18 to 75 years with a mean age of 38.7 years comprising 115 (78.8%) males and 31 (21.2%) females, were involved in the analysis. Upon initial screening, using fasting plasma glucose (FPG), 91.1 % had normal fasting level, 5.5 % had impaired fasting, and 3.4% were diagnosed with diabetes. Using 2-hour postprandial values (2HPP), 59.6% had normal plasma glucose, 28.8 % had impaired glucose tolerance (IGT), and 11.6 % were diagnosed with diabetes. Overall, the prevalence of dysglycaemia (i.e., impaired fasting and diabetes) was 8.9% (95% CI: 5.21–14.82%) with FPG test and 40.4% (95% CI: 32.68–48.65%) with 2HPP test. The analysis revealed that 2HPP was associated with high mean age compared to FPG (36.67 ± 13.97 versus 41.69 ± 13.97, p-value = 0.033). In addition, marital status was significantly associated with FPG status of patients (p = 0.028). Conclusion. The prevalence of dysglycaemia was high among smear positive TB patients in Ghana. Higher mean age and marital status were associated with abnormal glucose tolerance and fasting plasma glucose, respectively. Clinical management of patients with tuberculosis should include screening for diabetes.

Highlights

  • Tuberculosis (TB) infections continue to be a concern worldwide and it remains a deadly communicable disease

  • We found a high prevalence of dysglycaemia in our study (i.e., 8.9% and 40.4 %) by fasting and postprandial values, respectively, as well as diabetes of 3.4% and 11.6 % by fasting and 2-hour post-glucose values, respectively

  • A study by Joen et al found that the relative risk for TB among diabetes patients was 3.11 [5], while a review by Alisjahbana et al [6] suggested that the odds ratio of multidrug resistant (MDR) TB associated with diabetes patients is 2.1

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Summary

Introduction

Tuberculosis (TB) infections continue to be a concern worldwide and it remains a deadly communicable disease. Over 70% of these new cases occurred in developing countries with the African region experiencing the highest rate of death relative to the population [1]. A review by Steven et al reported that diabetes increases TB risk by 1.5- to 7.8-fold [4]. Another meta-analysis by Joen et al reported that the relative risk for TB among diabetes patients was 3.11 [5]. They stated that the prevalence of diabetes ranged from 1.9% to 35% after screening TB patients; the highest rates

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