Prevalence and risk factors for diabetes mellitus among tuberculosis patients in Moshi Municipal Council, Kilimanjaro Tanzania

Abstract

Background: Diabetes Mellitus (DM) is a worldwide public health problem and its prevalence has been rising rapidly in low and middle income countries (LMICs) including Tanzania. According to WHO report 2015, DM is ranked number six as a leading cause of death worldwide. Strong evidence suggests that DM may be associated with Tuberculosis (TB) and could affect TB treatment outcomes. Tanzania is among the 22 countries that have a high burden of TB and currently facing increased epidemic of DM. The increasing diabetes prevalence may be a threat to TB control and counteract strategies to end TB by 2030 as proposed by WHO. Objective: To determine proportion of TB patients who are co-infected with DM in Moshi municipal council, Kilimanjaro Tanzania. Methodology: This study was a hospital based cross-sectional study conducted in April to July 2018 at 4 health facilities; Mawenzi Regional Referral hospital, St. Joseph District Designated hospital, Pasua Health center and Majengo Health centre in Moshi municipal. The study included adults aged 18 years and above attending either of the 4 health facilities for TB care. The study included newly diagnosed and those who were on TB treatment. Interviews were conducted followed by blood glucose testing. Data was entered and analysed using SPSS Results: A total of 153 TB patients were enrolled, their mean age was 42.5 (±14.75) years and 46 (30.1%) were females. The prevalence of DM among TB patients in this study was 9.2%. Factors associated with TB-DM comorbidity were: age (OR 4.43, 95% CI: 1.18-16.55), HIV status (OR 3.88, 95% CI: 1.06-14.11), and family history of DM (OR 6.50, 95% CI 0.67-25.56). Conclusion: One in ten patients with TB had confirmed DM. There is a need for future studies to assess if DM influences TB treatment and outcomes in this setting.

Gambaran Foto Toraks Pasien Tuberkulosis Paru dengan Diabetes Melitus di RSUP Prof. Dr. R. D. Kandou Periode Januari – Juni 2022

“…Berdasarkan data didapatkan juga median usia subyek ialah 51 tahun, rerata usia 54,1 tahun, usia tertinggi yaitu 82 tahun dengan jumlah satu orang dan usia terendah ialah 36 tahun dengan jumlah satu orang (Tabel 3). Penelitian oleh Mabula et al 16 melaporkan bahwa angka kejadian TB paru dengan DM didominasi oleh usia di atas 40 tahun. Marcoa et al 17 mendapatkan bahwa usia rerata pengidap TB paru dengan DM ialah 49,2 tahun.…”

Implementing Innovative Approaches to Improve Health Care Delivery Systems for Integrating Communicable and Non-Communicable Diseases Using Tuberculosis and Diabetes as a Model in Tanzania

“…The ADEPT implementation included three regions-Dar es Salaam, Iringa and Kilimanjaro. Prevalence of DM in the general population in Dar es Salaam and Kilimanjaro is 9% and 5.7%, while the prevalence of DM in people with TB is estimated at 9.7% and 9.2%, respectively [7,21,22]. Studies of the magnitude of DM in the general population in Iringa were lacking, but one study found a prevalence of DM among people with TB of approximately 9% [23].…”

Prevalence of cardiovascular risk factors in active tuberculosis in Africa: a systematic review and meta-analysis

“…Among these studies, 79 (238,316 participants) were included in the meta-analysis for smoking, 67 (52,793 participants) for current alcohol use, 30 (31,450 participants) for hazardous alcohol use, 51 (37,879 participants) for DM, 19 (18,211 participants) for hypertension and 18 (13,910 participants) for obesity. Two studies (4320 participants) 29,30 reported on lipid abnormalities and another two studies 31,32 reported Prevalence of smoking. The pooled prevalence of any history of smoking was 26.0% (95% CI 22.0-29.0, I 2 = 99.6%, p < 0.001) and ranged from 1.4% in Uganda 33 to 82.5% in South Africa 34 .…”

“…of people with TB had low high density lipoproteins in Nigeria 29 while only 1.7% self-reported any lipid abnormalities in South Africa 30 . Physical inactivity, defined as a sedentary occupation and "no physical exercise", was reported in 49.8% of people with TB in Nigeria and 69.9% in Tanzania, respectively 31,32 . In the study from Nigeria, 32.9% had moderate activity and 17.3% had occupations associated with vigorous activity.…”