Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.
Department of Medicine, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
Sci Rep. 2017 Mar 10;7:44205. doi: 10.1038/srep44205.
Implementation studies are recommended to assess the feasibility and effectiveness of programmes. In Nigeria, little is known about the burden of diabetes mellitus (DM) among tuberculosis (TB) patients. The objective of this study was to determine screening efficacy, prevalence of DM and determinants of DM among TB patients. We report on a multi-centre implementation study carried-out in 13 health facilities in six States of Southern Nigeria. All newly diagnosed TB patients registered from March to October 2015 were screened for DM using current World Health Organisation guidelines. Overall, 2094 TB patients were evaluated, 196 (9.4%) were found to have DM. The prevalence of newly diagnosed DM was 5.5% (115/2094). DM prevalence varied according to age group; occurring in 2.2% of patients aged ≤ 25 years and 16.9% in patients aged (56-65) years. The additional yield of DM was 59% while the number needed to screen to detect a new case of DM was 18. Factors associated with DM were; age >40 years (aOR2.8, CI 2.1-3.9), rural residence (aOR2.3, 1.6-3.2), private health facility care (aOR2.0, 1.4-2.7), and having an occupation that engages in vigorous activity (aOR0.6, 0.4-0.9). The burden of DM among TB patients is high. Prioritization of DM screening for TB patients is indicated.
实施研究被推荐用于评估方案的可行性和有效性。在尼日利亚，人们对结核病（TB）患者中糖尿病（DM）的负担知之甚少。本研究的目的是确定 DM 在 TB 患者中的筛查效果、患病率和决定因素。我们报告了在尼日利亚南部六个州的 13 个卫生机构进行的一项多中心实施研究。2015 年 3 月至 10 月期间，所有新诊断的 TB 患者均按照当前世界卫生组织的指南进行 DM 筛查。共有 2094 例 TB 患者接受了评估，其中 196 例（9.4%）患有 DM。新发 DM 的患病率为 5.5%（115/2094）。DM 患病率随年龄组而变化；25 岁及以下患者的患病率为 2.2%，56-65 岁患者的患病率为 16.9%。DM 的额外检出率为 59%，而筛查 18 例即可发现 1 例新的 DM 病例。与 DM 相关的因素包括：年龄 >40 岁（OR2.8，95%CI 2.1-3.9）、农村居住（OR2.3，95%CI 1.6-3.2）、私营医疗机构就诊（OR2.0，95%CI 1.4-2.7）和从事剧烈活动的职业（OR0.6，95%CI 0.4-0.9）。TB 患者中 DM 的负担很高。建议优先对 TB 患者进行 DM 筛查。
