Diabetes Mellitus and Its Associated Factors in Tuberculosis Patients in Maekel Region, Eritrea: Analytical Cross-Sectional Study

Araia, Zenawi Zeramariam; Berhane, Araia; Mebrahtu, Amanuel Hadgu; Tewelde, Adiam Ghebreyohanns; Osman, Randa; Tuumzghi, Hagos Andom

doi:10.2147/dmso.s293557

Cited by 10 publications

(6 citation statements)

References 43 publications

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“…This model of screening and referral for both communicable and NCDs was considered an effective platform for diagnosing TB and NCDs concomitantly, especially in resource-limited settings. The need for such a platform is further emphasised in the cross-sectional study by Araia and colleagues in Eritrea, which points out the shared risk factors such as BMI for the development of TB and DM whereby only 54.5% of the patients in the study were aware that they have both conditions [ 56 ]. Furthermore, free screening using mobile units was deemed effective to reach participants in rural areas where screening for diabetes was performed using handheld glucometers and screening for hypertension performed with electronic sphygmomanometers [ 57 ].…”

Section: Resultsmentioning

confidence: 99%

Integrating tuberculosis and noncommunicable diseases care in low- and middle-income countries (LMICs): A systematic review

et al. 2022

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Background Low- and middle-income countries (LMICs) are facing a combined affliction from both tuberculosis (TB) and noncommunicable diseases (NCDs), which threatens population health and further strains the already stressed health systems. Integrating services for TB and NCDs is advantageous in tackling this joint burden of diseases effectively. Therefore, this systematic review explores the mechanisms for service integration for TB and NCDs and elucidates the facilitators and barriers for implementing integrated service models in LMIC settings. Methods and findings A systematic search was conducted in the Cochrane Library, MEDLINE, Embase, PubMed, Bibliography of Asian Studies, and the Global Index Medicus from database inception to November 4, 2021. For our search strategy, the terms “tuberculosis” AND “NCDs” (and their synonyms) AND (“delivery of healthcare, integrated” OR a range of other terms representing integration) were used. Articles were included if they were descriptions or evaluations of a management or organisational change strategy made within LMICs, which aim to increase integration between TB and NCD management at the service delivery level. We performed a comparative analysis of key themes from these studies and organised the themes based on integration of service delivery options for TB and NCD services. Subsequently, these themes were used to reconfigure and update an existing framework for integration of TB and HIV services by Legido-Quigley and colleagues, which categorises the levels of integration according to types of services and location where services were offered. Additionally, we developed themes on the facilitators and barriers facing integrated service delivery models and mapped them to the World Health Organization’s (WHO) health systems framework, which comprises the building blocks of service delivery, human resources, medical products, sustainable financing and social protection, information, and leadership and governance. A total of 22 articles published between 2011 and 2021 were used, out of which 13 were cross-sectional studies, 3 cohort studies, 1 case–control study, 1 prospective interventional study, and 4 were mixed methods studies. The studies were conducted in 15 LMICs in Asia, Africa, and the Americas. Our synthesised framework explicates the different levels of service integration of TB and NCD services. We categorised them into 3 levels with entry into the health system based on either TB or NCDs, with level 1 integration offering only testing services for either TB or NCDs, level 2 integration offering testing and referral services to linked care, and level 3 integration providing testing and treatment services at one location. Some facilitators of integrated service include improved accessibility to integrated services, motivated and engaged providers, and low to no cost for additional services for patients. A few barriers identified were poor public awareness of the diseases leading to poor uptake of services, lack of programmatic budget and resources, and additional stress on providers due to increased workload. The limitations include the dearth of data that explores the experiences of patients and providers and evaluates programme effectiveness. Conclusions Integration of TB and NCD services encourages the improvement of health service delivery across disease conditions and levels of care to address the combined burden of diseases in LMICs. This review not only offers recommendations for policy implementation and improvements for similar integrated programmes but also highlights the need for more high-quality TB–NCD research.

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Section: Resultsmentioning

confidence: 99%

Integrating tuberculosis and noncommunicable diseases care in low- and middle-income countries (LMICs): A systematic review

et al. 2022

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“…Another strength of this study is the use of LCA in providing information regarding clinically meaningful subgroups (19). More simplistic methods employed a fixed list of chronic conditions in defining chronic condition groups, our datadriven approach allowed inclusion of all observed diagnoses to identify distinct subgroups (20)(21)(22). This approach takes account for potentially joint comorbidity patterns between more severe chronic conditions such as heart failure and common illnesses like hypertension and gout, our study is capable of elucidating more detailed condition combinations.…”

Section: Discussionmentioning

confidence: 99%

Impact of Multimorbidity Subgroups on the Health Care Use and Clinical Outcomes of Patients With Tuberculosis: A Population-Based Cohort Analysis

Chen

Xiao

et al. 2021

Front. Public Health

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Background: Multimorbidity is defined as the existence of two or more chronic health conditions in the same individual. While patients with tuberculosis commonly have multiple conditions at diagnosis, such as HIV, diabetes, and depression, to the authors' knowledge, there is limited information on the patterns of multimorbidity, and how the types and combinations of conditions could impact the healthcare utilization, expenditure, and TB outcomes.Methods: An observational cohort study of adult patients diagnosed with tuberculosis was conducted using the Chinese Center for Disease Control and Prevention (CDC)'s National TB Information System (NTBIS) linked to the Ningbo Regional Health Care Database (NRHCD) (2015–2020). Latent class analysis was used to identify comorbidity groups among the subset with ≥2 conditions including TB. Group-level health care use, expenditure, and treatment outcomes were compared with patients without chronic conditions using multivariate regression models.Results: A total of 9,651 patients with TB were identified, of whom approximately 61.4% had no chronic conditions, 17.4% had 1 chronic condition, and 21.3% had ≥2 chronic conditions. Among those with ≥1 chronic condition other than TB, 4 groups emerged: (1) general morbidity (54.4%); (2) cardiovascular morbidity without complications (34.7%); (3) cardiovascular morbidity with complications (5.0%); (4) respiratory morbidity (5.9%). The respiratory morbidity group experienced the highest expenditures, at 16,360 CNY more overall (95% CI, CNY 12,615–21,215) after adjustment compared with TB patients without chronic conditions. The respiratory morbidity and cardiovascular morbidity with complications group also had the lowest odds of favorable TB outcomes [adjusted odds ratio (aOR), 0.68; 95% CI, 0.49–0.93] and (aOR 0.59, 95% CI 0.42–0.83), respectively. The cardiovascular morbidity without complications group had the highest odds of successful TB treatment (aOR, 1.40; 95% CI, 1.15–1.71).Conclusions: Multimorbidity is common among patients with TB. The current study identified four distinct comorbidity subgroups, all of which experienced high, yet differential, rates of health care use. These findings highlight the need for urgent reforms to transform current fragmented TB care delivery and improve access to other specialists and financial assistance.

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“…Penelitian oleh Utomo et al (2016) di Semarang juga memperoleh simpulan bahwa riwayat diabetes melitus dengan kejadian tuberkulosis saling berhubungan (p-value = 0,03). Penelitian oleh Araia et al (2021) di Afrika Bagian Timur menunjukkan kesamaan dengan penelitian ini yang menyebutkan riwayat diabetes melitus dan tuberkulosis saking berhubungan (p-value 0,001), dimana subjek dengan riwayat diabetes melitus 7 kali lebih rentan menderita tuberkulosis. Kesamaan juga ditemukan pada penelitian Yoo et al (2021) di Korea yang mengemukakan bahwa subjek dengan riwayat diabetes melitus lebih rentan 1,3 kali terjadi TBC dibandingkan subjek tanpa riwayat diabetes melitus.…”

Section: Riwayat Diabetes Melitus Dengan Kejadian Tuberkulosisunclassified

Analisis Faktor Risiko Tuberkulosis Berdasarkan Sistem Informasi Tuberkulosis di Kabupaten Malang Tahun 2020-2021

Ayu

Wardani

Alma

et al. 2023

SSH

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Indonesia is ranked third in the world as a country with the highest tuberculosis caseload. Malang Regency is one of the priority areas for tuberculosis in Indonesia. A host is affected by tuberculosis. Factors related to the host include age, sex, Human Immunodeficiency Virus (HIV) status, history of diabetes mellitus, and history of previous treatment. This study aims to determine the factors associated with the incidence of tuberculosis in Malang Regency based on Tuberculosis Information System data for 2020-2021. The sample size is 1,266 using cross-sectional as a study design. Data analysis in this study used univariate analysis, bivariate analysis with Chi-Square Test, and multivariate analysis with the Multiple Logistic Regression Test. The results obtained from this study were age (p equal to 0.000), gender (p equal to 0.497), HIV status (p equal to 0.003), history of diabetes mellitus (p equal to 0.000), and history of previous treatment (p equal to 0.265). The conclusions of this study indicate that age, Human Immunodeficiency Virus (HIV) status, and history of diabetes mellitus are associated with the incidence of tuberculosis. While gender and previous medical history were not related to the incidence of tuberculosis. History of diabetes mellitus OR equal to 2.575 (95 percent CI; 1.786-3.711) is the most dominant risk factor associated with the incidence of tuberculosis. Abstrak: Indonesia ditempatkan di peringkat ketiga di dunia sebagai negara dengan beban kasus tuberkulosis tertinggi. Kabupaten Malang merupakan salah satu wilayah prioritas tuberkulosis di Indonesia. Host merupakan pejamu yang mempengaruhi penyakit tuberkulosis. Faktor yang berkaitan dengan pejamu (host) antara lain usia, jenis kelamin, status Human Immunodeficiency Virus (HIV), riwayat diabetes melitus, dan riwayat pengobatan sebelumnya. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang berhubungan dengan kejadian tuberkulosis di Kabupaten Malang berdasarkan data Sistem Informasi Tuberkulosis tahun 2020-2021. Sampel berjumlah 1.266 dengan menggunakan cross sectional sebagai desain studi. Analisis data pada penelitian ini menggunakan analisis univariat, analisis bivariat dengan Uji Chi-Square, dan analisis multivariat dengan Uji Regresi Logistik Ganda. Diperoleh hasil dari penelitian ini variabel usia (p sama dengan 0,000), jenis kelamin (p sama dengan 0,497), status HIV (p sama dengan 0,003), riwayat diabetes melitus (p sama dengan 0,000), dan riwayat pengobatan sebelumnya (p sama dengan 0,265). Simpulan dari penelitian ini menunjukkan bahwa faktor usia, status Human Immunodeficiency Virus (HIV), dan riwayat diabetes melitus berhubungan dengan kejadian tuberkulosis. Sementara faktor jenis kelamin dan riwayat pengobatan sebelumnya tidak berhubungan dengan kejadian tuberkulosis. Riwayat diabetes melitus OR sama dengan 2,575 (CI 95 persen;1,786-3,711) merupakan faktor risiko yang paling dominan berhubungan dengan kejadian tuberkulosis.

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Diabetes Mellitus and Its Associated Factors in Tuberculosis Patients in Maekel Region, Eritrea: Analytical Cross-Sectional Study

Cited by 10 publications

References 43 publications

Integrating tuberculosis and noncommunicable diseases care in low- and middle-income countries (LMICs): A systematic review

Integrating tuberculosis and noncommunicable diseases care in low- and middle-income countries (LMICs): A systematic review

Impact of Multimorbidity Subgroups on the Health Care Use and Clinical Outcomes of Patients With Tuberculosis: A Population-Based Cohort Analysis

Analisis Faktor Risiko Tuberkulosis Berdasarkan Sistem Informasi Tuberkulosis di Kabupaten Malang Tahun 2020-2021

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