Factors associated with diabetes mellitus among adults with tuberculosis in a large European city, 2000–2013

Moreno-Martínez, Antonio; Casals, Martí; Orcau, Àngels; Gorrindo, Pilar; Masdeu, Eva; Caylà, Joan A.

doi:10.5588/ijtld.15.0102

Cited by 22 publications

(44 citation statements)

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“…Our finding was also comparable with the results of studies carried-out in Ethiopia (8.3%), Uganda (8.5%) and USA (11.4%)111220. However, DM prevalence among TB patients reported in this study was higher than the rates reported from China (6.3%), Spain (5.9%), Guinea-Bissau (2.8%) and Benin (1.9%); but lower than the rates reported from Taiwan (29.5%), Southern-Mexico (29.3%) and India (25.3%)13141516212223. Reason/s for the differences in prevalence might be due to disparities in patient background and disease burden.…”

Section: Discussioncontrasting

confidence: 68%

“…In addition, the low DM prevalence observed in these settings may also be explained by the high burden of TB among younger persons, who in general have a lower incidence of DM than those aged (40 years or over)24. Furthermore, differences in dietary habits and the screening methods used for DM diagnosis might contribute to the variation in prevalence of DM among TB patients in various regions13141516212223.…”

Section: Discussionmentioning

confidence: 99%

“…Owing to the differences between the various studies, it is crucial to understand the relationship between TB and DM in different regions around the world in order to establish appropriate priorities and adapt the needs of National TB Control Programmes. In high TB burden countries with weak public health systems, the current recommendation is to rule out TB among diabetics and vice versa151726. Given the low NNS noted in our setting to detect a DM case, and the need to sustain DM-TB screening programmes in Nigeria, the most cost-effective approach would be to prioritise older TB patients for targeted screening.…”

Section: Discussionmentioning

confidence: 99%

“…However, recent studies have shown that DM prevalence among TB cases is variable. It ranges from about 50% reported by some studies in India, about 30% in Mexico, less than 10% in the United States, to even lower values in certain African countries, Spain and China10111213141516. As reported levels of co-morbidity vary highly, National TB Control Programmes (NTPs) will need to decide whether such DM screening is needed.…”

mentioning

confidence: 99%

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Screening for diabetes mellitus among tuberculosis patients in Southern Nigeria: a multi-centre implementation study under programme settings

Ekeke¹,

Ukwaja

Chukwu³

et al. 2017

Sci Rep

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Implementation studies are recommended to assess the feasibility and effectiveness of programmes. In Nigeria, little is known about the burden of diabetes mellitus (DM) among tuberculosis (TB) patients. The objective of this study was to determine screening efficacy, prevalence of DM and determinants of DM among TB patients. We report on a multi-centre implementation study carried-out in 13 health facilities in six States of Southern Nigeria. All newly diagnosed TB patients registered from March to October 2015 were screened for DM using current World Health Organisation guidelines. Overall, 2094 TB patients were evaluated, 196 (9.4%) were found to have DM. The prevalence of newly diagnosed DM was 5.5% (115/2094). DM prevalence varied according to age group; occurring in 2.2% of patients aged ≤ 25 years and 16.9% in patients aged (56–65) years. The additional yield of DM was 59% while the number needed to screen to detect a new case of DM was 18. Factors associated with DM were; age >40 years (aOR2.8, CI 2.1–3.9), rural residence (aOR2.3, 1.6–3.2), private health facility care (aOR2.0, 1.4–2.7), and having an occupation that engages in vigorous activity (aOR0.6, 0.4–0.9). The burden of DM among TB patients is high. Prioritization of DM screening for TB patients is indicated.

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Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Screening for diabetes mellitus among tuberculosis patients in Southern Nigeria: a multi-centre implementation study under programme settings

Ekeke¹,

Ukwaja

Chukwu³

et al. 2017

Sci Rep

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“…HIV coinfection and malnutrition were also reported as low risk factor for TBDM comorbidity [72, 95]. HIV coinfection with injection drug use (IDU) or without IDU was reported as low risk factor for TBDM coexistence [88]. TBDM comorbid patients were more likely to be PTB case, smear- positive, to have anti-TB drug resistance, to have cavitary lesions on chest x-ray, and to have high alanine transaminase (ALT) level [10, 25, 28, 30, 48, 54, 56, 88–89, 72, 76, 84, 88, 95, 100].…”

Section: Resultsmentioning

confidence: 99%

Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review

2017

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IntroductionThe dual burden of tuberculosis (TB) and diabetes mellitus (DM) has become a major global public health concern. There is mounting evidence from different countries on the burden of TB and DM comorbidity. The objective of this systematic review was to summarize the existing evidence on prevalence and associated/risk factors of TBDM comorbidity at global and regional levels.MethodsOvid Medline, Embase, Global health, Cochrane library, Web of science and Scopus Elsevier databases were searched to identify eligible articles for the systematic review. Data were extracted using standardized excel form and pilot tested. Median with interquartile range (IQR) was used to estimate prevalence of TBDM comorbidity. Associated/risk factors that were identified from individual studies were thematically analyzed and described.ResultsThe prevalence of DM among TB patients ranged from 1.9% to 45%. The overall median global prevalence was 16% (IQR 9.0%-25.3%) Similarly, the prevalence of TB among DM patients ranged from 0.38% to 14% and the overall median global prevalence was 4.1% (IQR 1.8%-6.2%). The highest prevalence of DM among TB patients is observed in the studied countries of Asia, North America and Oceania. On the contrary, the prevalence of TB among DM patients is low globally, but relatively higher in the studied countries of Asia and the African continents. Sex, older age, urban residence, tobacco smoking, sedentary lifestyle, poor glycemic control, having family history of DM and TB illness were among the variables identified as associated/risk factors for TBDM comorbidity.ConclusionThis systematic review revealed that there is a high burden of DM among TB patients at global level. On the contrary, the global prevalence of TB among DM patients is low. Assessing the magnitude and risk/associated factors of TBDM comorbidity at country/local level is crucial before making decisions to undertake TBDM integrated services.

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Impact of diabetes mellitus on tuberculosis prevention, diagnosis, and treatment from an immunologic perspective

Ye,

Li,

Yang

et al. 2024

Exploration

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The coexistence of diabetes mellitus (DM) and tuberculosis (TB) presents a significant global burden, with DM being recognized as a major risk factor for TB. This review comprehensively analyzes the immunological aspects of DM‐TB comorbidity, shedding light on the impact of DM on TB pathogenesis and immune responses. It reveals that high blood glucose levels in TB patients contribute to reduced innate immune cell count, compromised phagocytic function, and delayed antigen presentation. These factors ultimately impair the clearance of Mycobacterium tuberculosis (MTB) and delay adaptive immune responses. With the interaction between TB and DM, there is an increase in inflammation and elevated secretion of pro‐inflammatory cytokines by immune cells. This exacerbates the inflammatory response and contributes to poor treatment outcomes in TB. Moreover, the review explores the effects of DM on TB prevention, diagnosis, and treatment. It highlights how poor glycemic control, insulin resistance (IR), DM complications, and genetic factors increase the risk of MTB infection in individuals with DM. Additionally, DM‐related immune suppression adversely affects the sensitivity of traditional diagnostic tests for TB, potentially resulting in underdiagnosis and delayed intervention. To mitigate the burden of TB in DM patients, the review emphasizes the need for further research on the mechanisms underlying DM reactivation in latent TB infection (LTBI). It shows how important it is to find and treat LTBI in DM patients as soon as possible and suggests looking into biomarkers that are specific to DM to make diagnosis more accurate.

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Factors associated with diabetes mellitus among adults with tuberculosis in a large European city, 2000–2013

Abstract: DM prevalence among adults with TB in Barcelona is low and remained stable over the 14-year study period. However, TB patients with DM were potentially more infectious and their clinical management was more complicated.

Cited by 22 publications

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Screening for diabetes mellitus among tuberculosis patients in Southern Nigeria: a multi-centre implementation study under programme settings

Screening for diabetes mellitus among tuberculosis patients in Southern Nigeria: a multi-centre implementation study under programme settings

Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review

Impact of diabetes mellitus on tuberculosis prevention, diagnosis, and treatment from an immunologic perspective

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