German Leprosy and TB Relief Association, Nigeria.
University of Nigeria Teaching Hospital, Enugu, Nigeria.
Adv Respir Med. 2020;88(1):6-12. doi: 10.5603/ARM.2020.0072.
Diabetes mellitus (DM) and tuberculosis (TB) are of great public health importance globally, especially in Sub-Saharan Africa. Tuberculosis is the third cause of death among subjects with non-communicable diseases. DM increases risk of progressing from latent to active tuberculosis. The study aimed to ascertain yield of TB cases and the number needed to screen (NNS) among DM patients.
Across-sectional study was conducted at 10 health facilities with high DM patient load and readily accessible DOTS center in 6 states of southern region of Nigeria over aperiod of 6 months under routine programme conditions. All patients who gave consent were included in the study. Yield and NNS were calculated using an appropriate formula.
3 457 patients were screened with amean age (SD) of 59.9 (12.9) years. The majority were male, 2 277 (65.9%). Overall prevalence of TB was 0.8% (800 per 100 000). Sixteen (0.5%) were known TB cases (old cases). There were 221 presumptive cases (6.4%) out of which 184 (83.3%) were sent for Xpert MTB/Rif assay. Eleven (0.3%) new cases of TB were detected, giving additional yield of 40.7% and the number needed to screen (NNS) of 315. All the 11 patients were placed on anti-TB treatment.
The prevalence of TB among DM patients was higher than in the general population. The yield was also good and comparable to other findings. This underscores the need for institute active screening for TB among DM patients. Further stu-dies are recommended to identify associated factors to guide policy makers in planning and development of TB-DM integrated services.
糖尿病（DM）和结核病（TB）在全球范围内都具有重要的公共卫生意义，尤其是在撒哈拉以南非洲地区。结核病是导致非传染性疾病患者死亡的第三大原因。DM 会增加从潜伏性结核发展为活动性结核的风险。本研究旨在确定 DM 患者中结核病病例的检出率和筛查所需人数（NNS）。
在尼日利亚南部地区的 6 个州，选择 10 个 DM 患者人数较多且可方便到达 DOTS 中心的卫生机构，在常规项目条件下进行了一项为期 6 个月的横断面研究。所有同意参加的患者均纳入研究。使用适当的公式计算了检出率和 NNS。
共筛查了 3457 名患者，平均年龄（标准差）为 59.9（12.9）岁。大多数为男性，2277 名（65.9%）。TB 的总患病率为 0.8%（每 10 万人中有 800 例）。16 例（0.5%）为已知的 TB 病例（旧病例）。有 221 例疑似病例（6.4%），其中 184 例（83.3%）被送往 Xpert MTB/Rif 检测。发现 11 例新的 TB 病例，额外检出率为 40.7%，筛查所需人数（NNS）为 315。所有 11 例患者均接受了抗 TB 治疗。
DM 患者中结核病的患病率高于一般人群。检出率也很好，与其他研究结果相当。这强调了在 DM 患者中进行主动 TB 筛查的必要性。建议进行进一步的研究，以确定相关因素，为规划和制定 TB-DM 综合服务提供指导。
