<p>Diabetes Mellitus and Tuberculosis Comorbidity and Associated Factors Among Bale Zone Health Institutions, Southeast Ethiopia</p>

Abstract

Background: Globally, tuberculosis and diabetes mellitus co-morbidity is higher than tuberculosis and human immunodeficiency virus comorbidity. Considering this, the World Health Organization and the International Union against tuberculosis and lung disease recommend bidirectional screening of the two diseases. However, in Ethiopia, bi-directional screening has not been started yet. Objective: The objective of this study was to assess the prevalence of diabetes mellitus and tuberculosis comorbidity and its predictors among adult tuberculosis patients in Bale Zone Health Institutions, Southeastern Ethiopia. Materials and Methods: Institutional-based cross-sectional study carried out using interviewer administered questionnaire, registration review, anthropometric and blood glucose level measurement from March, 30, 2019 to April, 30, 2019. Three hundred twenty-one tuberculosis patients were selected from tuberculosis registration log book using lottery methods. The collected data were checked for completeness, coded and entered in to EpiData3.0.2 and exported to SPSS version 20. Independent variables that had p value less 0.25 were used as candidates for multiple logistic regressions to control confounders. Variables that had significant association were identified by calculating odds ratio, with 95% confidence interval, and p value less than 0.05 used to declare statistical significance. Results: Diabetes mellitus and tuberculosis comorbidity among adult tuberculosis patients was 5.1% (95% CI: 2.7%, 7.5%). Age with ≥50 years (AOR=3.98, 95% CI: 1.13, 14.36), having extra pulmonary tuberculosis (AOR=3.31, 95% CI: 1.16, 9.44) and being females (AOR=3.8, 95% CI: 1.17, 12.33) were significantly associated with the comorbidity of the two diseases. Conclusion and Recommendation: The prevalence of diabetes mellitus and tuberculosis comorbidity was high. Female tuberculosis patients, tuberculosis patients with age ≥50 years and those having extra pulmonary tuberculosis patients should be screened for diabetes mellitus.

Prevalence and risk factors of type-2 diabetes mellitus in Ethiopia: systematic review and meta-analysis

“…Among the studies included in this meta-analysis, older age individuals were more exposed to type-2 diabetes than the younger age group, which is supported by the study 1 , 2 , 5 , 9 , 17 , 18 , 20 , 22 – 24 , 26 , 28 , 32 , 33 , 38 , 51 , 56 . In contrast, our study 11 , 23 , 35 , 45 had got the result that contradict the other studies and concluded age had no any effect over the development of DM. Ten studies were examined the association between hypertension and DM 32 , 34 , 36 , 43 , 49 , and the result shows that a person with blood pressure ≥ 140 mm Hg was 2.48 times more likely to develop type-2 diabetes (OR: 2.48, 95% CI: 1.47, 4.18) (Fig.…”

“…We use twelve studies to examine the association of education with DM and seven studies to investigate the association of physical activity with DM. Of 12 studies that examined the association of education level with type-2 DM, five studies supported that education level was associated with type-2 DM 11 , 45 , 48 . Among seven studies included in the analysis, six studies 10 , 43 , 47 – 49 showed that physical activity had a significant contribution to the prevalence of type-2 DM (Fig.…”

“…Thirteen studies had examined the association of age with type-2 DM 21 , 23 , 27 , 31 , 34 , 41 , 42 , 45 , 46 , 48 . Five of the studies had shown a statistically significant association of age with type-2 DM 18 , 21 , 31 , 43 , 45 , 48 whereas the remaining seven studies have shown that age had no significant effect on type-2 DM.…”

“…Thirteen studies had examined the association of age with type-2 DM 21 , 23 , 27 , 31 , 34 , 41 , 42 , 45 , 46 , 48 . Five of the studies had shown a statistically significant association of age with type-2 DM 18 , 21 , 31 , 43 , 45 , 48 whereas the remaining seven studies have shown that age had no significant effect on type-2 DM. Consequently, the pooled meta-regression analysis showed that older age ≥ 40 years were statistical associated with type-2 DM (OR: 1.91, 95% CI: 1.05, 3.49), and cholesterol level ≥ 200 mg/dl was 1.31 times more likely to be exposed for diabetes (OR: 1.31, 95% CI: 0.28, 6.04) as compared cholesterol level < 200 mg/dl (Fig.…”

Subjects With Diabetes Mellitus Are at Increased Risk for Developing Tuberculosis: A Cohort Study in an Inner-City District of Barcelona (Spain)

“…In a report from Perú, DM was described as the most frequent comorbidity in patients with TB ( 29 ). In another work done in Ethiopia, DM had a high prevalence between patients with TB ( 30 ).…”