Estimation of the Proportion and Determinants of Diabetes Mellitus Among Notified Tuberculosis Patients in Jaipur, Rajasthan, India.

BACKGROUND

Tuberculosis (TB) and diabetes mellitus (DM) comorbidity is a significant public health problem globally and in India. The present study estimated the proportion and determinants of DM among notified TB patients within the Indian National Tuberculosis Elimination Program (NTEP).

METHODS

The present study is the secondary data analysis of the NTEP data obtained from the District Tuberculosis Office, Jaipur, Rajasthan, India. The total number of TB patients included in the study was 4679. Sociodemographic and clinical data were compared between TB-DM and TB-only patients. Bivariate chi-squared analysis and multivariate logistic regression analysis were employed to understand the determinants of TB-DM comorbidity.

RESULTS

The proportion of DM among the notified TB patients was found to be 0.98% (46). TB-DM patients were significantly older (a mean age of 51.6±12.4 years vs. 34.2±17.3 years; p<0.001) and had higher body weight (51.2±11.4 kg vs. 46.2±12.4 kg; p<0.05) than TB-only patients. Bivariate analysis revealed that males and individuals over 35 years of age had higher odds of TB-DM, with odds ratios of 1.906 (95% CI: 1.015-3.582) and 29.871 (95% CI: 7.233-123.363), respectively. Multivariate binary logistic regression analysis determined that age >=35 years was a significant determinant of TB-DM comorbidity (adjusted odds ratio (AOR): 28.641; 95% CI: 6.818-120.313; p<0.001). There was no significant association of treatment success rate and death rate with TB-DM comorbidity. The comparison of diagnostic and enrollment facilities in diagnosing and enrolling TB-DM revealed that the diagnostic and enrollment of TB-DM patients were higher in private healthcare facilities than in public healthcare facilities.

CONCLUSION

The study results determined that age >35 years is the significant determinant of TB-DM comorbidity. The analysis of diagnostic and enrollment facilities showed that TB-DM patients were more likely to be diagnosed and enrolled in private hospitals than government healthcare facilities. The study findings suggest that there is a need for integrated management approaches that address TB and DM concurrently.