Abera Ademe, Ameya Gemechu
Hawassa Comprehensive Specialized Hospital, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
Open Microbiol J. 2018 Oct 18;12:333-342. doi: 10.2174/1874285801812010333. eCollection 2018.
Developing countries have a high burden of Tuberculosis (TB); although it is considered as a disease of the past in most developed countries. The end TB strategy was predicted to stabilize or drop the incidence of TB. However, the rising of the prevalence of immune-related diseases like Diabetes Mellitus (DM) are challenging the TB control strategy in high TB burden region. The objective of this study was to determine the prevalence and associated factors of pulmonary tuberculosis in DM patients attending Adare Hospital, south Ethiopia.
A cross-sectional study was carried out on 207 randomly selected diabetic patients at the Adare hospital. A structured pre-tested questionnaire was used during the data collection from participants. Sputum concentration technique followed by Ziehl-Neelsen staining method was used to examine pulmonary tuberculosis. Logistic regression analysis was used to assess the association between various variables and pulmonary tuberculosis. Odds ratios and 95% CI were computed to determine the strength and presence of the association.
The prevalence of pulmonary tuberculosis among diabetics was 5.3% [95% CI: (2.2, 8.4)]. Diabetic patients who were underweight [AOR = 9.94, 95% CI: (1.51-80.89)], had more than 10 years duration with DM [AOR = 7.03 95% CI: (1.357, 73.6)], Alcohol drinking habit [AOR = 12.49, 95% CI: (3.28, 77.94)], and history of contact with TB [AOR = 5.35, 95% CI: (1.1-39.12)] were the factors positively associated with pulmonary TB infection while being HIV seronegative had a negative association with pulmonary TB infection [AOR =0.074, 95% CI: (0.001-0.29)].
High proportion of pulmonary TB was observed in diabetic patients as compared to the national estimated prevalence of TB in the total population. Duration of patient with DM, being underweight, alcohol consumption habit, and contact history with TB were positively associated with pulmonary TB infection while being HIV seronegative had a negative association with the infection in diabetic patients.
发展中国家结核病负担沉重；而在大多数发达国家，结核病被视为一种过去的疾病。终结结核病战略预计会使结核病发病率稳定或下降。然而，诸如糖尿病（DM）等免疫相关疾病患病率的上升，正给结核病高负担地区的结核病控制策略带来挑战。本研究的目的是确定在埃塞俄比亚南部阿达雷医院就诊的糖尿病患者中肺结核的患病率及相关因素。
在阿达雷医院对207名随机选取的糖尿病患者进行了一项横断面研究。在从参与者收集数据期间，使用了一份经过预测试的结构化问卷。采用痰浓缩技术随后进行萋尼氏染色法来检测肺结核。使用逻辑回归分析来评估各种变量与肺结核之间的关联。计算比值比和95%置信区间以确定关联的强度和存在情况。
糖尿病患者中肺结核的患病率为5.3% [95%置信区间：(2.2, 8.4)]。体重过轻的糖尿病患者[AOR = 9.94，95%置信区间：(1.51 - 80.89)]、糖尿病病程超过10年的患者[AOR = 7.03，95%置信区间：(1.357, 73.6)]、有饮酒习惯的患者[AOR = 12.49，95%置信区间：(3.28, 77.94)]以及有结核病接触史的患者[AOR = 5.35，95%置信区间：(1.1 - 39.12)]是与肺结核感染呈正相关的因素，而HIV血清学阴性与肺结核感染呈负相关[AOR = 0.074，95%置信区间：(0.001 - 0.29)]。
与全国总体人群结核病估计患病率相比，糖尿病患者中肺结核比例较高。糖尿病患者的病程、体重过轻、饮酒习惯以及结核病接触史与肺结核感染呈正相关，而HIV血清学阴性与糖尿病患者的感染呈负相关。
