Pulmonary Tuberculosis (PTB) Prevalence & Factors in Diabetic Patients with Poor Glycemic Control In Mwanza
Downloads
Introduction: Tuberculosis (TB) remains a global health threat. Diabetes mellitus (DM) is a critical risk factor for TB, particularly in patients with poor glycemic control.
Objective: To investigate the prevalence and associated factors of newly diagnosed pulmonary tuberculosis (PTB) among poorly controlled diabetic patients in Mwanza, Tanzania.
Methods: A cross-sectional study was conducted in two hospitals, enrolling adult diabetic patients with poor glycemic control. Data were collected through questionnaires, physical examinations, laboratory tests (FBG/RBG, HbA1c, GeneXpert, chest X-ray), and BMI calculation. The primary outcome was newly diagnosed PTB. Statistical analysis was performed using STATA.
Results: Among 97 participants, 59.8% were male, 74.2% were under 60 years old (mean age 48 years), and 81% had HbA1c exceeding 7%. The prevalence of newly diagnosed PTB was 18.6%, of which 12.4% were GeneXpert-positive and 6.2% were clinically/radiologically diagnosed. Obesity was a significant risk factor for PTB (OR=4.4, p=0.006). Overweight and age under 60 also showed higher PTB risk.
Conclusion: Diabetics with poor glycemic control, obesity, overweight, age under 60, and abnormal chest X-rays are at high risk for PTB and require screening. Early detection and control are crucial for preventing TB spread in this vulnerable population.
Downloads
Organization, 2019). Abera, R. G., Demesse, E. S., & Boko, W. D. (2022). Evaluation of glycemic control and related factors among outpatients with type 2 diabetes at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia: a cross-sectional study. BMC endocrine disorders, 22(1), 54.
Alexander, M., Gupta, A., & Mathad, J. (2019). Is there a connection between gestational diabetes mellitus, human immunodeficiency virus infection, and tuberculosis? The International Journal of Tuberculosis and Lung Disease, 23(1), 19-25.
Anyanwu, M. O., Ajumobi, O. O., Afolabi, N. B., Usman, A., & Kehinde, A. (2022). Diabetes mellitus and its associated factors among patients with tuberculosis attending directly observed treatment centres in Oyo State, Nigeria: a cross-sectional evaluation. BMJ open, 12(4).
Barber, T. M. (2020). COVID-19 and diabetes mellitus: implications for prognosis and clinical management. Expert Review of Endocrinology & Metabolism, 15(4), 227-236.
Bart Jurriaan, t. H. (2015). Structural violence, Diabetes and Agrocolonialism. A case study of the United States, Mexico, India and the Pacific Islands.
Bates, M., Marais, B. J., & Zumla, A. (2015). Tuberculosis comorbidity with communicable and noncommunicable diseases. Cold Spring Harbor perspectives in medicine, 5(11).
Boillat-Blanco, N., Bovet, P., Ramaiya, K. L., Mganga, M., Minja, L. T., Saleh, L., . . . Daubenberger, C. (2016). Association between tuberculosis, diabetes and 25 hydroxyvitamin D in Tanzania: a longitudinal case control study. BMC infectious diseases, 16(1), 1-9.
Gupta, S., Koirala, J., Khardori, R., & Khardori, N. (2007). Infections in diabetes mellitus and hyperglycemia. Infectious disease clinics of North America, 21(3), 617-638.
Huang, L.-K., Wang, H.-H., Lai, Y.-C., & Chang, S.-C. (2017). The impact of glycemic status on radiological manifestations of pulmonary tuberculosis in diabetic patients. Plos one, 12(6), e0179750.
Ji, Y., Cao, H., Liu, Q., Li, Z., Song, H., Xu, D., . . . Wang, J. (2020). Screening for pulmonary tuberculosis in high-risk groups of diabetic patients. International Journal of Infectious Diseases, 93, 84-89.
Kapur, A., & Harries, A. D. (2013). The double burden of diabetes and tuberculosis–public health implications. Diabetes research and clinical practice, 101(1), 10-19.
Khalid, N., Ahmad, F., & Qureshi, F. M. (2021). Association amid the comorbidity of Diabetes Mellitus in patients of Active Tuberculosis in Pakistan: A matched case control study. Pakistan Journal of Medical Sciences, 37(3), 816.
Khattab, M., Khader, Y. S., Al-Khawaldeh, A., & Ajlouni, K. (2010). Factors associated with poor glycemic control among patients with type 2 diabetes. Journal of Diabetes and its Complications, 24(2), 84-89.
McMurry, H. S., Mendenhall, E., Rajendrakumar, A., Nambiar, L., Satyanarayana, S., & Shivashankar, R. (2019). Coprevalence of type 2 diabetes mellitus and tuberculosis in low‐income and middle‐income countries: a systematic review. Diabetes/metabolism research and reviews, 35(1), e3066.
Milo, R. B., & Connelly, C. D. (2019). Predictors of glycemic management among patients with type 2 diabetes. Journal of clinical nursing, 28(9-10), 1737-1744.
Mtwangambate, G., Kalluvya, S., Kidenya, B., Kabangila, R., Downs, J., Smart, L., . . . Peck, R. (2014). ‘Cough‐triggered’tuberculosis screening among adults with diabetes in Tanzania. Diabetic medicine, 31(5), 600-605.
Naqshbandi, M., Harris, S. B., Esler, J. G., & Antwi-Nsiah, F. (2008). Global complication rates of type 2 diabetes in Indigenous peoples: A comprehensive review. Diabetes research and clinical practice, 82(1), 1-17.
Obels, I., Ninsiima, S., Critchley, J. A., & Huangfu, P. (2022). Tuberculosis risk among people with diabetes mellitus in Sub‐Saharan Africa: a systematic review. Tropical Medicine & International Health, 27(4), 369-386.
Organization, W. H. (2019). WHO guidelines on tuberculosis infection prevention and control: 2019 update: World Health Organization.
Otu, A., Hashmi, M., Mukhtar, A. M., Kwizera, A., Tiberi, S., Macrae, B., . . . Mer, M. (2018). The critically ill patient with tuberculosis in intensive care: Clinical presentations, management and infection control. Journal of critical care, 45, 184-196.
Pal, R., Ansari, M. A., Hameed, S., & Fatima, Z. (2016). Diabetes mellitus as hub for tuberculosis infection: A snapshot. International journal of chronic diseases, 2016.
Segura-Cerda, C. A., López-Romero, W., & Flores-Valdez, M. A. (2019). Changes in host response to mycobacterium tuberculosis infection associated with type 2 diabetes: beyond hyperglycemia. Frontiers in cellular and infection microbiology, 9, 342.
Stegenga, M. E., van der Crabben, S. N., Blümer, R. M., Levi, M., Meijers, J. C., Serlie, M. J., . . . van der Poll, T. (2008). Hyperglycemia enhances coagulation and reduces neutrophil degranulation, whereas hyperinsulinemia inhibits fibrinolysis during human endotoxemia. Blood, The Journal of the American Society of Hematology, 112(1), 82-89.
Ugarte-Gil, C., Alisjahbana, B., Ronacher, K., Riza, A. L., Koesoemadinata, R. C., Malherbe, S. T., . . . Lopez, S. (2020). Diabetes mellitus among pulmonary tuberculosis patients from 4 tuberculosis-endemic countries: the TANDEM study. Clinical Infectious Diseases, 70(5), 780-788.
Wang, Y., Dou, M., Kou, T., Liu, Y., Lv, W., Han, L., . . . Schouten, E. G. (2021). Risk of having pulmonary tuberculosis in type 2 diabetes: A hospital-based matched case-control study. Asia Pacific Journal of Clinical Nutrition, 30(2), 303-310.
Wu, Z., Guo, J., Huang, Y., Cai, E., Zhang, X., Pan, Q., & Shen, X. (2016). Diabetes mellitus in patients with pulmonary tuberculosis in an aging population in Shanghai, China: Prevalence, clinical characteristics and outcomes. Journal of Diabetes and its Complications, 30(2), 237-241.
Yu, Y., Kong, Y., Ye, J., & Wang, A. (2020). Performance of conventional histopathology and GeneXpert MTB/RIF in the diagnosis of spinal tuberculosis from bone specimens: a prospective clinical study. Clinical Biochemistry, 85, 33-37.
Copyright (c) 2024 Sr. Gotfrida Marandu, Gaston Ng'onyanyi, Paul Alikado Sabuni
This work is licensed under a Creative Commons Attribution 4.0 International License.
