Diabetes mellitus among patients attending TB clinics in Dar es Salaam: a descriptive cross-sectional study

Munseri, Patricia; Kimambo, Henrika; Pallangyo, Kisali

doi:10.1186/s12879-019-4539-5

Cited by 19 publications

(24 citation statements)

References 33 publications

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“…The prevalence of DM among TB cases in the current study was 9.9% which is more than two folds higher than the occurrence of DM in the general population of Eritrea. 14 This is consistent to ndings from Tanzania (9.7%) and pooled DM prevalence of Sub-Sahara Africa (9%) 20,21 but lower than the pooled global DM prevalence (15.3%) in patients with active tuberculosis. 22 Contradicting results of lower [23][24][25][26] and higher DM prevalence among TB cases were also reported in different countries.…”

Section: Discussionsupporting

confidence: 80%

TB-diabetes comorbidity and associated factors in Maekel Zone, Eritrea: A cross sectional study.

Araia

Berhane

Mebrahtu

et al. 2021

Preprint

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Background: Both diabetes mellitus (DM) and tuberculosis (TB) are among the leading causes of morbidity and mortality in Eritrea. TB-DM comorbidity is known to complicate TB care, control and prevention. However, systematically studied epidemiological data on TB-DM comorbidity and its associated risk factors is lacking in this country. Objective: This study aimed to assess the prevalence of DM and its associated factors among TB patients in Maekel region, Eritrea.Methods: Analytical cross-sectional study was conducted in eleven TB diagnostic and treatment sites. Pretested data extraction tool was used to collect data from medical records. Prevalence data was analysed using frequencies, proportions and median. To determine DM risk factors, univariable and multivariable logistic regression analysis was done with 95%CI and p value < 0.05 considered significant. Results: Out of total eligible (1,134) TB cases, DM prevalence was 9.88%. Age and BMI were identified as independent risk factors for DM among TB patients. Higher odds of DM was found among TB patients aged 45-54 (aOR: 4.85[1.39-16.94], p= 0.013) and those ≥ 55 (aOR: 6.99[2.12-23.04], p= 0.001). TB cases with normal BMI were two times more likely to have DM (aOR: 2.00[1.23-3.26], p= 0.005) compared to those underweight. Conclusion: The prevalence of DM among TB cases observed in this study is high, a clarion call to scale up current efforts to integrate TB-DM services within routine care. Furthermore, age and BMI were identified as independent risk factors for DM in TB cases, pointing to the need to pay attention to age and BMI status when managing this co-morbidityKey words: TB-DM prevalence, transient hyperglycaemia, fasting blood glucose, pre-diabetes, Eritrea.

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Section: Discussionsupporting

confidence: 80%

TB-diabetes comorbidity and associated factors in Maekel Zone, Eritrea: A cross sectional study.

Araia

Berhane

Mebrahtu

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…The prevalence of DM among TB cases in the current study was 9.9% which is more than two folds higher than the occurrence of DM in the general population of Eritrea. 14 This is consistent to findings from Tanzania (9.7%) and pooled DM prevalence of Sub-Sahara Africa (9%) 20,21 but lower than the pooled global DM prevalence (15.3%) in patients with active tuberculosis. 22 Contradicting results of lower [23][24][25][26] and higher DM prevalence among TB cases were also reported in different countries.…”

Section: Discussionsupporting

confidence: 79%

“…This is much higher than earlier finding from Ethiopia (6.4%) but lower than the reports from Tanzania (60%) and Kenya (69.5%). 20,30,31 Despite the fact that our study did not provide data on the types of DM among TB cases, most DM patients in Eritrea are suffering from type 2 DM. 32 Due to its gradual development, most patients with Type 2 DM experience minimal symptoms.…”

Section: Discussionmentioning

confidence: 88%

“…This finding is consistent to previous studies which noted higher odds of DM in older TB patients. 20 , 25 , 39 On the other hand, a study conducted in Ethiopia found that not only old but young TB patients aged 26–40 had higher probabilities of being diabetic. 30 Nearly three fourth of the TB-DM cases in the current study were ≥45 years old but this age group account for only 46% of the study population.…”

Section: Discussionmentioning

confidence: 99%

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Diabetes Mellitus and Its Associated Factors in Tuberculosis Patients in Maekel Region, Eritrea: Analytical Cross-Sectional Study

Araia¹,

Berhane²,

Mebrahtu³

et al. 2021

DMSO

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Background Both diabetes mellitus (DM) and tuberculosis (TB) are among the leading causes of morbidity and mortality in Eritrea. TB-DM comorbidity is known to complicate TB care, control and prevention. However, systematically studied epidemiological data on TB-DM comorbidity and its associated risk factors are lacking in this country. Objective This study aimed to assess the prevalence of DM and its associated factors among TB patients in the Maekel region, Eritrea. Methods Analytical cross-sectional study was conducted in eleven TB diagnostic and treatment sites. Pretested data extraction tool was used to collect data from medical records. Prevalence data were analysed using frequencies, proportions and median. To determine DM risk factors, univariable and multivariable logistic regression analysis was done with 95% CI and p value < 0.05 considered significant. Results Out of total eligible (1134) TB cases, DM prevalence was 9.88%. Age and BMI were identified as independent risk factors for DM among TB patients. Higher odds of DM were found among TB patients aged 45–54 (aOR: 4.85[1.39–16.94], p= 0.013) and those ≥55 (aOR: 6.99[2.12–23.04], p= 0.001). TB cases with normal BMI were two times more likely to have DM (aOR: 2.00[1.23–3.26], p= 0.005) compared to those underweight. Conclusion The prevalence of DM among TB cases observed in this study is high, a clarion call to scale up current efforts to integrate TB-DM services within routine care. Furthermore, age and BMI were identified as independent risk factors for DM in TB cases, pointing to the need to pay attention to age and BMI status when managing this co-morbidity.

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“…While the widespread use of ART is reducing HIV/AIDS related morbidity and mortalityespecially due to TB co-infection which is the leading cause of death in HIV positive peopleit could potentially fuel the resurgence of diabetes-associated TB [8,[15][16][17]. The relationship between TB and DM is well established [18] and studies have shown that diabetes increases the risk of developing active TB, recurrent TB and severe TB disease and results in worse TB treatment outcomes [19][20][21][22][23][24][25]. The threat of a TB-DM dual epidemic in South Africa is a cause for concern given that the country is in the top eight highest TB burden countries, and in 2019 accounted for 3.6% of the global total of people who developed active TB [26], and the trilateral overlap with HIV may therefore have implications for TB control [27].…”

Section: Introductionmentioning

confidence: 99%

Diabetes in a TB and HIV-endemic South African population: Analysis of a virtual cohort using routine health data

et al. 2021

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Background It is widely accepted that people living with diabetes (PLWD) are at increased risk of infectious disease, yet there is a paucity of epidemiology studies on the relationship between diabetes and infectious disease in SSA. In a region with a high burden of infectious disease, this has serious consequences for PLWD. Methods and findings Using routinely collected longitudinal health data, we describe the epidemiology of diabetes in a large virtual cohort of PLWD who have a high burden of HIV and TB, from the Khayelitsha subdistrict in the Western Cape Province in South Africa. We described the relationship between previous TB, newly diagnosed TB disease and HIV infection on diabetes using HbA1c results as an outcome measure. The study population was predominately female (67%), 13% had a history of active TB disease and 18% were HIV positive. The HIV positive group had diabetes ascertained at a significantly younger age (46 years c.f. 53 years respectively, p<0.001) and in general had increased HbA1c values over time after their HIV diagnosis, when compared to the HIV-negative group. There was no evidence of TB disease influencing the trajectory of glycaemic control in the long term, but diabetes patients who developed active TB had higher mortality than those without TB (12.4% vs 6.7% p-value < 0.001). HIV and diabetes are both chronic diseases whose long-term management includes drug therapy, however, only 52.8% of the study population with an HIV-diabetes comorbidity had a record of diabetes treatment. In addition, the data suggest overall poor glycaemic control in the study population with only 24.5% of the participants having an HbA1c <7% at baseline despite 85% of the study population being on diabetes treatment. Conclusion The epidemiologic findings in this exploratory study highlight the need for further research into diabetes outcomes in a high TB and HIV burden setting and demonstrate that routine health data are a valuable resource for understanding disease epidemiology in the general population.

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Diabetes mellitus among patients attending TB clinics in Dar es Salaam: a descriptive cross-sectional study

Cited by 19 publications

References 33 publications

TB-diabetes comorbidity and associated factors in Maekel Zone, Eritrea: A cross sectional study.

TB-diabetes comorbidity and associated factors in Maekel Zone, Eritrea: A cross sectional study.

Diabetes Mellitus and Its Associated Factors in Tuberculosis Patients in Maekel Region, Eritrea: Analytical Cross-Sectional Study

Diabetes in a TB and HIV-endemic South African population: Analysis of a virtual cohort using routine health data

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