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The prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in Cape Town, South Africa

Background: The number of studies addressing the association between diabetes mellitus (DM) and tuberculosis (TB) in the context of sub - Saharan Africa (SSA) is limited and fewer studies have determined whether DM is associated with TB among patients attending DM c linics. We aimed to assess the pr...

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Main Author: O'Jiaku-Okorie, Adaeze
Other Authors: Oni, Tolullah
Format: Thesis
Language:English
Published: Institute of Infectious Disease and Molecular Medicine 2016
Subjects:
Epidemiology
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access_status_str Open Access
author O'Jiaku-Okorie, Adaeze
author2 Oni, Tolullah
author_browse O'Jiaku-Okorie, Adaeze
Oni, Tolullah
author_facet Oni, Tolullah
O'Jiaku-Okorie, Adaeze
author_sort O'Jiaku-Okorie, Adaeze
collection Thesis
description Background: The number of studies addressing the association between diabetes mellitus (DM) and tuberculosis (TB) in the context of sub - Saharan Africa (SSA) is limited and fewer studies have determined whether DM is associated with TB among patients attending DM c linics. We aimed to assess the prevalence of TB among a population, diagnosed and receiving treatment for DM at a primary care clinic, and to identify significant risk factors of prevalent TB cases. Methods In this cross - sectional study, adult DM patients attending an outpatient clinic at a South African township were evaluated for TB using Xpert MTB/RIF testing (Xpert) and other conventional methods - clinical symptom screening, smear microscopy, chest x - ray, and culture. Socio - demographic and biochemical information were collected using the Who's STEPwise approach to surveillance of chronic disease risk factors. Findings 451 DM patients were screened for TB. 16 DM patients were diagnosed with TB, following screening giving a prevalence rate of 3 · 55% or 35 · 48 per 1000 people [95% CI: 2 · 18 - 5 · 72]. 37 · 50% (n=6) of TB cases reported at least one clinical symptom of TB [95% CI: 17 · 34 - 63 · 11%]. 62 · 5% (n=10; 95% CI :) of TB cases were HIV - positive. In a multivariate analysis, HIV (OR : 14 · 58 , p<0 · 001) and haemoptysis (OR 24 · 48, p<0 · 001) were strongly associated with prevalent TB. Identified associations were not modified by age or gender. There were no significant differences in either fasting plasma glucose or HbA1c levels between TB and non - TB DM participants. Discussion Prevalence of TB among DM population was higher than in the general population based on national estimates, highlighting an important DM - TB association in an SSA setting. HIV as a significant risk factor for TB confirms its position as a major driver in TB epidemic overall and in T2DM patients. Two - thirds of prevalent TB cases reported no TB symptoms, suggesting further research is needed to identify more accurate TB screening strategies for DM patients, particularly in HIV - infected persons, to facilitate early detection and treatment of prevalent TB in this population group.
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institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:51:56.680Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2016
publishDateRange 2016
publishDateSort 2016
publisher Institute of Infectious Disease and Molecular Medicine
publisherStr Institute of Infectious Disease and Molecular Medicine
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source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/21375 The prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in Cape Town, South Africa O'Jiaku-Okorie, Adaeze Oni, Tolullah Epidemiology Background: The number of studies addressing the association between diabetes mellitus (DM) and tuberculosis (TB) in the context of sub - Saharan Africa (SSA) is limited and fewer studies have determined whether DM is associated with TB among patients attending DM c linics. We aimed to assess the prevalence of TB among a population, diagnosed and receiving treatment for DM at a primary care clinic, and to identify significant risk factors of prevalent TB cases. Methods In this cross - sectional study, adult DM patients attending an outpatient clinic at a South African township were evaluated for TB using Xpert MTB/RIF testing (Xpert) and other conventional methods - clinical symptom screening, smear microscopy, chest x - ray, and culture. Socio - demographic and biochemical information were collected using the Who's STEPwise approach to surveillance of chronic disease risk factors. Findings 451 DM patients were screened for TB. 16 DM patients were diagnosed with TB, following screening giving a prevalence rate of 3 · 55% or 35 · 48 per 1000 people [95% CI: 2 · 18 - 5 · 72]. 37 · 50% (n=6) of TB cases reported at least one clinical symptom of TB [95% CI: 17 · 34 - 63 · 11%]. 62 · 5% (n=10; 95% CI :) of TB cases were HIV - positive. In a multivariate analysis, HIV (OR : 14 · 58 , p<0 · 001) and haemoptysis (OR 24 · 48, p<0 · 001) were strongly associated with prevalent TB. Identified associations were not modified by age or gender. There were no significant differences in either fasting plasma glucose or HbA1c levels between TB and non - TB DM participants. Discussion Prevalence of TB among DM population was higher than in the general population based on national estimates, highlighting an important DM - TB association in an SSA setting. HIV as a significant risk factor for TB confirms its position as a major driver in TB epidemic overall and in T2DM patients. Two - thirds of prevalent TB cases reported no TB symptoms, suggesting further research is needed to identify more accurate TB screening strategies for DM patients, particularly in HIV - infected persons, to facilitate early detection and treatment of prevalent TB in this population group. 2016-08-19T13:17:54Z 2016-08-19T13:17:54Z 2016 Master Thesis Masters MPH http://hdl.handle.net/11427/21375 eng application/pdf Institute of Infectious Disease and Molecular Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Epidemiology
O'Jiaku-Okorie, Adaeze
The prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in Cape Town, South Africa
thesis_degree_str Master's
title The prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in Cape Town, South Africa
title_full The prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in Cape Town, South Africa
title_fullStr The prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in Cape Town, South Africa
title_full_unstemmed The prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in Cape Town, South Africa
title_short The prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in Cape Town, South Africa
title_sort prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in cape town south africa
topic Epidemiology
url http://hdl.handle.net/11427/21375
work_keys_str_mv AT ojiakuokorieadaeze theprevalenceanddeterminantsofactivetuberculosisamongdiabetespatientsattendingaprimaryhealthcareclinicincapetownsouthafrica
AT ojiakuokorieadaeze prevalenceanddeterminantsofactivetuberculosisamongdiabetespatientsattendingaprimaryhealthcareclinicincapetownsouthafrica

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