Tulu Begna, Amsalu Eden, Zenebe Yohannes, Abebe Melkamu, Fetene Yeshimebet, Agegn Manamnot, Abate Alemayehu, Ponpetch Keerati, Bekana Teshome, Gumi Balako, Ameni Gobena
Department of Medical Laboratory Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis AbabaAddis Ababa, Ethiopia.
Trop Med Health. 2021 Aug 28;49(1):68. doi: 10.1186/s41182-021-00358-4.
The prevalence of diabetes mellitus (DM) is increasing globally and its comorbidity with tuberculosis (TB) is re-emerging, especially in low- and middle-income countries.
The main aim of this study is to determine the prevalence of DM and HIV infection and their associated risk factors among active tuberculosis patients in Northwest Ethiopia.
This hospital-based cross-sectional study was conducted between February 1st and June 30th, 2017 among active TB patients in two hospitals of Northwest Ethiopia. Two hundred and sixty-seven active TB cases aged 18 years or older were screened for diabetes using fasting blood glucose (FBG) test. Semi-structured questionnaires were used to collect demographic data, lifestyle habits and clinical data. Identification of pre-diabetes or diabetes in TB patients was achieved according to American Diabetes Association guidelines (2016).
Prevalence of DM and TB comorbidity was 11.5% (95% confidence interval, CI 7.8-15.2) compared to 24.9% (95% CI 20.1-30.1) for pre-diabetes. Prevalence of HIV/TB co-infection was 21.9% (95% CI 16.7-26.8). Risk of DM was higher in TB patients from a rural location (adjusted odds ratio, aOR 3.13, 95% CI 1.02-9.62, p = 0.046). Similarly, DM was higher in TB patients who have a family history of DM (aOR 4.54, 95% CI 1.31-15.68, p = 0.017). Furthermore, HIV/TB co-infection was identified as a predictor of DM comorbidity in active TB patients (aOR 5.11, 95% CI 2.01-12.98, p = 0.001).
The magnitude of DM and pre-diabetes in active TB patients in Northwest Ethiopia was high, warranting collaborative efforts to improve screening and adopt better clinical management strategies for DM-TB comorbid patients. Furthermore, being rural residents, family history of DM and HIV/TB co-infection were found to associate with DM among TB patients, highlighting the importance of the above-mentioned risk factors in the clinical management of this comorbidity.
全球糖尿病（DM）患病率呈上升趋势，且糖尿病与结核病（TB）的合并症再度出现，尤其是在低收入和中等收入国家。
本研究的主要目的是确定埃塞俄比亚西北部活动性肺结核患者中糖尿病和艾滋病毒感染的患病率及其相关危险因素。
2017年2月1日至6月30日，在埃塞俄比亚西北部两家医院对活动性肺结核患者进行了这项基于医院的横断面研究。对267例年龄在18岁及以上的活动性肺结核病例进行空腹血糖（FBG）检测以筛查糖尿病。使用半结构化问卷收集人口统计学数据、生活习惯和临床数据。根据美国糖尿病协会指南（2016年）确定肺结核患者中的糖尿病前期或糖尿病。
糖尿病与结核病合并症的患病率为11.5%（95%置信区间，CI 7.8 - 15.2），而糖尿病前期的患病率为24.9%（95%CI 20.1 - 30.1）。艾滋病毒/结核病合并感染的患病率为21.9%（95%CI 16.7 - 26.8）。来自农村地区的肺结核患者患糖尿病的风险更高（调整后的优势比，aOR 3.13，95%CI 1.02 - 9.62，p = 0.046）。同样，有糖尿病家族史的肺结核患者患糖尿病的风险更高（aOR 4.54，95%CI 1.31 - 15.68，p = 0.017）。此外，艾滋病毒/结核病合并感染被确定为活动性肺结核患者糖尿病合并症的一个预测因素（aOR 5.11，95%CI 2.01 - 12.98，p = 0.001）。
埃塞俄比亚西北部活动性肺结核患者中糖尿病和糖尿病前期的比例很高，需要共同努力改善筛查，并为糖尿病 - 结核病合并症患者采用更好的临床管理策略。此外，发现农村居民、糖尿病家族史和艾滋病毒/结核病合并感染与肺结核患者中的糖尿病有关，突出了上述危险因素在这种合并症临床管理中的重要性。
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