High rates of undiagnosed diabetes mellitus among patients with active tuberculosis in Addis Ababa, Ethiopia.
Diabetes mellitus
Early detection
Mortality
Risk scoring
Tuberculosis
Journal
Journal of clinical tuberculosis and other mycobacterial diseases
ISSN: 2405-5794
Titre abrégé: J Clin Tuberc Other Mycobact Dis
Pays: England
ID NLM: 101682877
Informations de publication
Date de publication:
May 2022
May 2022
Historique:
entrez:
14
3
2022
pubmed:
15
3
2022
medline:
15
3
2022
Statut:
epublish
Résumé
Tuberculosis (TB) and diabetes mellitus (DM) have negative synergistic impact on each other. Global guidelines recommend collaborative efforts to address this synergy, but implementation has been slow. Part of the reason is lack of adequate evidence on the operational feasibility of existing tools and mechanisms of collaboration. The objective of this study was to assess the yield of DM screening among TB patients using risk scoring tools combined with blood tests as a feasible strategy for early detection to improve TB/DM treatment outcomes. Between September 2020 and December 2021, we conducted a cross-sectional study among patients receiving TB treatment in public health facilities in Addis Ababa, Ethiopia. Trained health workers collected data on symptoms and risk scoring checklists before testing for random and fasting blood glucose levels. We used logistic regression analyses techniques to determine factors associated with increased DM detection. A receiver-operating characteristic curve was constructed to determine the performance of the risk scoring checklist. Of 2381 TB patients screened, 197 (8.3%) had DM of which 48.7% were newly diagnosed. Having a family history of DM predicted DM with Odds Ratio (OR) of 5.36 (95% Confidence Interval, [3.67, 7.83]) followed by age ≥ 45 years (OR = 4.64, [3.18, 6.76]). Having one or more "symptoms" of DM was a significant predictor (OR 2.88, 95% CI, 2.06-4.01). Combining risk scores with symptoms predicted DM diagnosis with sensitivity of 94.7%, but specificity was low at 29.4%. In patients with known treatment outcome status, death rate was high. Almost a half of TB patients with DM did not know their status. A simple tool that combined risk factors with symptoms accurately predicted a subsequent diagnosis of DM. Such tools can help avoid high rates of death among TB patients suffering from DM through early detection.
Sections du résumé
Background
UNASSIGNED
Tuberculosis (TB) and diabetes mellitus (DM) have negative synergistic impact on each other. Global guidelines recommend collaborative efforts to address this synergy, but implementation has been slow. Part of the reason is lack of adequate evidence on the operational feasibility of existing tools and mechanisms of collaboration. The objective of this study was to assess the yield of DM screening among TB patients using risk scoring tools combined with blood tests as a feasible strategy for early detection to improve TB/DM treatment outcomes.
Methods
UNASSIGNED
Between September 2020 and December 2021, we conducted a cross-sectional study among patients receiving TB treatment in public health facilities in Addis Ababa, Ethiopia. Trained health workers collected data on symptoms and risk scoring checklists before testing for random and fasting blood glucose levels. We used logistic regression analyses techniques to determine factors associated with increased DM detection. A receiver-operating characteristic curve was constructed to determine the performance of the risk scoring checklist.
Results
UNASSIGNED
Of 2381 TB patients screened, 197 (8.3%) had DM of which 48.7% were newly diagnosed. Having a family history of DM predicted DM with Odds Ratio (OR) of 5.36 (95% Confidence Interval, [3.67, 7.83]) followed by age ≥ 45 years (OR = 4.64, [3.18, 6.76]). Having one or more "symptoms" of DM was a significant predictor (OR 2.88, 95% CI, 2.06-4.01). Combining risk scores with symptoms predicted DM diagnosis with sensitivity of 94.7%, but specificity was low at 29.4%. In patients with known treatment outcome status, death rate was high.
Conclusions
UNASSIGNED
Almost a half of TB patients with DM did not know their status. A simple tool that combined risk factors with symptoms accurately predicted a subsequent diagnosis of DM. Such tools can help avoid high rates of death among TB patients suffering from DM through early detection.
Identifiants
pubmed: 35284658
doi: 10.1016/j.jctube.2022.100306
pii: S2405-5794(22)00011-0
pmc: PMC8904591
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
100306Informations de copyright
© 2022 The Authors.
Déclaration de conflit d'intérêts
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Références
Diabetol Metab Syndr. 2021 Oct 30;13(1):127
pubmed: 34717728
Diabetes Res Clin Pract. 2014 Nov;106(2):191-9
pubmed: 25082309
Diabetes Ther. 2018 Aug;9(4):1421-1429
pubmed: 29869049
Curr Opin Endocrinol Diabetes Obes. 2009 Apr;16(2):95-9
pubmed: 19276801
Int J Tuberc Lung Dis. 2011 Jul;15(7):871-85
pubmed: 21496360
East Afr Med J. 1999 Jul;76(7):361-4
pubmed: 10520361
Diabetes Res Clin Pract. 2022 Jan;183:109119
pubmed: 34879977
J Diabetes Res. 2019 Apr 28;2019:4134937
pubmed: 31183383
J Endocrinol Invest. 2021 Jan;44(1):75-81
pubmed: 32342446
PLoS One. 2016 Jan 25;11(1):e0147621
pubmed: 26808967
Ann Intern Med. 2009 Dec 1;151(11):775-83
pubmed: 19949143
Int Health. 2017 Mar 1;9(2):100-104
pubmed: 28338880
Open Forum Infect Dis. 2016 Jun 16;3(3):ofw126
pubmed: 27419188
Int J Tuberc Lung Dis. 2019 Jul 1;23(7):783-796
pubmed: 31439109
Indian J Endocrinol Metab. 2014 Jul;18(4):475-9
pubmed: 25143901
Ann Intern Med. 2009 Jun 2;150(11):741-51
pubmed: 19487709
BMJ. 2021 Oct 12;375:n2239
pubmed: 34642172
Diabetes Care. 2003 Mar;26(3):725-31
pubmed: 12610029
Diabetes Care. 2005 May;28(5):1187-94
pubmed: 15855587
BMC Infect Dis. 2021 Aug 21;21(1):855
pubmed: 34418980
Thorax. 2017 Mar;72(3):263-270
pubmed: 27553224