College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
College of Nursing, University of Saskatchewan, Saskatoon, Canada.
BMC Infect Dis. 2019 Mar 13;19(1):254. doi: 10.1186/s12879-019-3892-8.
Tuberculosis 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.
Four 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 I 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.
In 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.
Diabetes 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.
结核病和糖尿病是全球重大公共卫生挑战。在撒哈拉以南非洲，关于结核病患者中糖尿病患病率的研究结果不一致且差异很大。因此，本系统评价和荟萃分析估计了撒哈拉以南非洲结核病患者中糖尿病的总体患病率。
系统检索了四个国际数据库（PubMed、Google Scholar、Science Direct 和 Cochrane Library）。我们纳入了所有报告撒哈拉以南非洲地区结核病患者中糖尿病患病率的观察性研究。两位作者（CT 和 AA1）使用标准化数据提取格式提取了本综述所需的所有数据。采用 STATA 版本 14 统计软件进行荟萃分析。使用 Cochrane Q 检验统计量和 I 检验评估研究的异质性。最后，计算了一个随机效应荟萃分析模型，以估计结核病患者中糖尿病的 pooled 患病率。此外，还根据不同因素进行了亚组分析。
在荟萃分析中，有 16 项研究符合纳入标准并被纳入。这 16 项研究的结果表明，撒哈拉以南非洲地区结核病患者中糖尿病的 pooled 患病率为 9.0%（95%CI：6.0，12.0%）。在尼日利亚，结核病患者中糖尿病的患病率最高（15%），其次是坦桑尼亚（11%），然后是埃塞俄比亚（10%）。此外，HIV 感染的结核病患者中糖尿病的患病率为（8.9%），略高于 HIV 未感染的结核病患者（7.7%）。
撒哈拉以南非洲地区结核病患者中糖尿病的患病率明显较高。此外，本研究发现，HIV 感染的结核病患者中 DM 的患病率高于未感染的结核病患者。强烈建议对结核病患者进行 DM 筛查，特别应重视对 TB/HIV 合并感染患者的早期 DM 筛查。
