Tuberculosis and diabetes mellitus in the Republic of Kiribati: a case–control study

Abstract

Abstractobjectives To better inform local management of TB-diabetes collaborative activities, we aimed to determine the prevalence of diabetes among persons with and without TB and to determine the association between TB and diabetes in Kiribati, a Pacific Island nation.methods We compared consecutively enrolled TB cases to a group of randomly selected community controls without evidence of TB. Diabetes was diagnosed by HbA1c, and clinical and demographic data were collected. A tuberculin skin test was administered to controls. The chi-square test was used to assess significance in differences between cases and controls. We also calculated an odds ratio, with 95% confidence intervals, for the odds of diabetes among cases relative to controls. Unweighted multivariate logistic regression was performed to adjust for the effects of age and sex.results A total of 275 TB cases and 499 controls were enrolled. The diabetes prevalence in cases (101, 37%) was significantly greater than in controls (94, 19%) (adjusted odds ratio: 2.8; 95% CI 2.0-4.1). Fifty-five percent (108) of all diabetic diagnoses were new; this proportion was higher among controls (64.8%) than cases (46.5%). Five patients with TB were screened to detect one patient with diabetes.conclusions There is a strong association between TB and diabetes in Kiribati and bidirectional screening should be conducted in this setting.

Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review

“…This variation might be due to differences in the screening methods used and variations in the prevalence of DM in the general population of the respective countries. However, the large proportion of newly identified DM patients suggests the identification of previously undiagnosed DM patients and highlights that screening TB patients for DM in the TB clinic is an important public health intervention [102]. …”

Diabetes and tuberculosis: An important relationship

“…Further, during the study period, pulmonary TB incidence rates in people with diabetes increased by 83%, whereas rates in non‐diabetic people decreased by 27% . In the Pacific Island nation of Kiribati, diabetes prevalence was 37% among cases with TB, but 19% among controls, with an adjusted odds ratio for diabetes of 2.8 . Much of the diabetes associated with TB may be undiagnosed.…”

Diabetes Mellitus among Newly Diagnosed Tuberculosis Patients in Tribal Odisha: An Exploratory Study

“…Understanding the interaction between the two diseases is important since they have implications for achieving the 2035 WHO targets for TB incidence and mortality. Accordingly, several studies [5,7,[9][10][11][12] have been initiated to investigate the coexistence of diabetes with TB. In India, various community and hospital based studies have noted a varied prevalence of glucose intolerance among TB patients [13][14][15][16][17].…”