Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: a systematic review and meta-analysis of observational studies

Abstract

BackgroundTuberculosis and diabetes mellitus are significant global public health challenges. In Sub-Saharan Africa, study findings regarding prevalence of diabetes mellitus amongst tuberculosis patients have been inconsistent and highly variable. Therefore, this systematic review and meta-analysis estimates the overall prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa.MethodsFour international databases (PubMed, Google Scholar, Science Direct and Cochrane Library) were systematically searched. We included all observational studies reporting the prevalence of DM among TB patients in Sub-Saharan Africa. All necessary data for this review were extracted using a standardized data extraction format by two authors (CT and AA1). STATA Version 14 statistical software was employed to conduct meta-analysis. The Cochrane Q test statistics and I2 test were used to assess the heterogeneity of the studies. Finally, a random effects meta-analysis model was computed to estimate the pooled prevalence of diabetes mellitus in TB patients. Besides, subgroup analysis was done based on different factors.ResultsIn the meta-analysis, sixteen studies fulfilled the inclusion criteria and were included. The findings of these 16 studies revealed that the pooled prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa was 9.0% (95% CI: 6.0, 12.0%). The highest prevalence of diabetes mellitus among tuberculosis patients was found in Nigeria (15%), followed by Tanzania (11%), and then Ethiopia (10%). Besides, the prevalence of diabetes mellitus among HIV infected TB patients was (8.9%) which is slightly higher than HIV uninfected (7.7%) TB patients.ConclusionDiabetes mellitus among tuberculosis patients in Sub-Saharan Africa was significantly high. Moreover, this study found that there was a high prevalence of DM among HIV infected than uninfected TB patients. It is strongly recommended to screen for DM among TB patients and special emphasis should be given for early screening of DM among TB/HIV co-infected patients.Electronic supplementary materialThe online version of this article (10.1186/s12879-019-3892-8) contains supplementary material, which is available to authorized users.

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

“…The prevalence of DM among TB cases in the current study was 9.9% which is more than two folds higher than the occurrence of DM in the general population of Eritrea. 14 This is consistent to findings from Tanzania (9.7%) and pooled DM prevalence of Sub-Sahara Africa (9%) 20 , 21 but lower than the pooled global DM prevalence (15.3%) in patients with active tuberculosis. 22 Contradicting results of lower 23–26 and higher DM prevalence among TB cases were also reported in different countries.…”

Diabetes among tuberculosis patients and its impact on tuberculosis treatment in South Asia: a systematic review and meta-analysis

“…www.nature.com/scientificreports/ Data extraction and quality assessment. Two authors independently (SG and SM) extracted the data into a piloted data collection form adapted from Alebel et al 9 and Noubiap et al 3 with necessary modifications. Extracted data for assessing the prevalence of diabetes among TB patients include characteristics of studies, publication date, period of data collection, country included in the study, study design, sampling technique, sample size, gender and mean age of participants, diabetic cases among TB patients, method of data collection, a diagnostic method for TB and diabetes.…”

“…The authors were contacted to provide additional information if needed. A modified version adapted from Alebel et al 9 of New castle Ottawa scales (NOS) was used to evaluate the quality of the included studies. The NOS scale assess risk of bias in three domains and assigns higher points for low risk of bias in each domain with maximum of nine points: (1) selection of study groups (four points); (2) comparability of groups (two points); and (3) ascertainment of outcomes (three points) .…”

“…The NOS scale assess risk of bias in three domains and assigns higher points for low risk of bias in each domain with maximum of nine points: (1) selection of study groups (four points); (2) comparability of groups (two points); and (3) ascertainment of outcomes (three points) . Studies with six points or higher were deemed to at of low risk of bias and consequently of high quality 9 .…”

“…The risk of bias of the included studies was evaluated using the Newcastle Ottawa scales (NOS) adapted from Alebel et al 9 with slight modification. Only one-third of the studies (34) were judged to have a low risk of bias.…”