Prognostic factors among TB and TB/DM comorbidity among patients on short course regimen within Nairobi and Kiambu counties in Kenya

Abstract

BackgroundThe double burden of diabetes mellitus (DM) and pulmonary tuberculosis (TB) is one of the global health challenges. Studies done in different parts of the world indicate that 12%-44% of TB disease is associated with DM. In Kenya TB-DM co-morbidity data is scarce and is not readily available. In this study we set to determine the difference in treatment outcomes among TB and TB/DM comorbidity patients and their respective clinical and socio-demographic characteristics.ObjectiveTo determine prognostic factors among TB and TB/DM comorbidity among patients on short course regimen within Nairobi and Kiambu counties in Kenya.MethodsWe carried out a prospective cohort study of non-pregnant patients aged 15 years and above that tested positive for TB in two peri‑urban counties in Kenya between February 2014 and August 2015. Clinical and socio demographic data were obtained from a questionnaire and medical records of the National TB program patient data base at two, three, five and six months. The data consisted of TB status, HIV status, TB lineage, County, (Glucose, %HbA1c, creatinine) weight, height, BMI, regimen, sex, level of education, employment status, distance from health facility, number of cigarettes smoked, home size, and diet. Univariate analysis was then used to compare each potential risk factor in the TB and TB/DM patients by the Pearson x2 test of proportions or fisher exact test, as appropriate.ResultsDM prevalence (HbA1c > 6%) among TB infected patients was 37.2%. Regimen, employment status, alcohol intake, smoking, age and household size were some of the factors associated with DM among TB patients at p-value < 0.05. The number of cigarettes smoked per day and the value of the BUN were significant risk factors of developing DM among TB patients (p values = 0.045). Mean time to conversion from positive to negative was slightly higher for the TB-DM patients compared to the TB patents, though not statistically significant (p = 0.365).ConclusionPatients regimen, employment status, alcohol intake, smoking, age and are associated with DM among TB patients.

Genetic variation of ABCB1 (rs1128503, rs1045642) and CYP2E1 rs3813867 with the duration of tuberculosis therapy: a pilot study among tuberculosis patients in Indonesia

“…In Malaysia, employment status as a determinant of TB infection was showed that patients who were unemployed completed TB therapy at higher rates [ 35 ]. Our result was similar to a study in Kenya [ 41 ]. Productive age and employed status of individuals are risk factors for TB infection because of high mobility and the increased likelihood of being exposed to TB [ 35 , 42 ].…”

Gradient association between pulmonary tuberculosis and diabetes mellitus among households with a tuberculosis case: a contact tracing-based study

“…The positive relationship between excessive edible oil intake and DM is plausible as absorption of more lipids results in overweight, which has been shown to be a risk factor of DM 37 . In addition, in the present study, compared to Han ethnicity, people from the Buyi ethnic minority group were 1.37 (95% CI 0.98, 1.90) times more likely to develop DM, which might be due to the different lifestyle and cultural customs 38 . In our study, no gender difference was found, which is different from that in the previous studies in India 39 and Zambia 40 .…”

A Systematic Review of Substance Use and Substance Use Disorder Research in Kenya

“…Tobacco use among adults was associated with being male (45,59,65). Several health factors were linked to tobacco use including hypertension (65), development of oral leukoplakia (34), pneumonia (82), increased odds esophageal cancer (77), ischemic stroke (83) and diabetes mellitus (70). In addition, tobacco use was associated with having had an injury in the last 12 months (81), emotional abuse (48) and psychological IPV (73).…”