Prevalence and factors associated with the Tuberculosis (TB) and Diabetes (DM) co-occurrence: a cross sectional study from Sri Lanka

Abstract

Background: Co-occurrence of TB and DM is associated with increased morbidity and mortality. Objectives: To determine the prevalence and factors associated with TB-DM co-occurrence Methods: A cross sectional study was conducted, in the National hospital for respiratory Diseases, Sri Lanka from April to December 2014. Eligible patients with TB underwent fasting blood sugar screening on admission. Results: 428 patients were enrolled, in which 65.7% were males and the median age was 50 (18- 80) years. Majority (82.7%) were Sinhalese, followed by Tamils (8.9%), Moors (M) (7.2%) and other (1.3%). Majority (58.6%) had smear positive-pulmonary TB, followed by extra-pulmonary TB (22%), smear negative-pulmonary TB (13.3%), treatment for relapses(3.3%) treatment for previous defaults(2.6%), and treatment for previous failure(0.2%). Prevalence of DM was found to be 30.8% in which 3% were newly diagnosed. Prevalence of pre DM was 8.4%. DM patients had higher sputum smear positivity at the diagnosis (odds ratio (OR) 2.7(1.7-4.2)) compared with non DM patients. Age>50 years (OR 2.5(1.6-3.9)) and M (OR 3.4(1.6-7.2)) ethnicity were significantly associated with TB-DM co-occurrence. Conclusion: This study illustrates a higher prevalence of TB-DM co-occurrence when compared to similar studies done in the region. Patients with DM were at a higher risk of sputum smear positivity therefore higher infectivity. Elderly and M ethnicity had a higher risk for TB-DM co-occurrence.