1
|
Byashalira KC, Chamba NG, Alkabab Y, Mbelele PM, Ntinginya NE, Ramaiya KL, Alimohamed MZ, Heysell SK, Mmbaga BT, Bygbjerg IC, Christensen DL, Mpagama SG, Lillebaek T. Clinical-demographic markers for improving diabetes mellitus diagnosis in people with tuberculosis in Tanzania. BMC Infect Dis 2022; 22:260. [PMID: 35296241 PMCID: PMC8925287 DOI: 10.1186/s12879-022-07249-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 03/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Tuberculosis (TB) control is threatened by an increasing prevalence of diabetes mellitus (DM), particularly in endemic countries. Screening for DM is not routinely implemented in Tanzania; therefore, we aimed to screen for DM at TB diagnosis using clinical-demographic markers. Methods Our cross-sectional study recruited TB patients who received anti-TB treatment between October 2019 and September 2020 at health care facilities in three regions from Tanzania. Patients were screened for DM using DM symptoms (polydipsia, polyphagia and polyuria) and random blood glucose (RBG) testing. Patients with a history of DM and those with no history of DM but an RBG ≥ 7.8 mmol/L had point-of-care glycated haemoglobin (HbA1c) testing, and were considered to have DM if HbA1c was ≥ 48 mmol/mol. Results Of 1344 TB patients, the mean age was 41.0 (± 17.0) years, and 64.7% were male. A total of 1011 (75.2%) had pulmonary TB, and 133 (10.4%) had at least one DM symptom. Overall, the prevalence of DM was 7.8%, of which 36 (2.8%) TB patients with no history of DM were newly diagnosed with DM by RBG testing. TB/DM patients were older than those with only TB (50.0 ± 14.0 years vs 40.0 ± 17.0 years, p < 0.001). Patients with RBG ≥ 7.8 mmol/L were more likely to have pulmonary TB (p = 0.003), age ≥ 35 years (p = 0.018), and have at least one DM symptom (p < 0.001). There was a substantial agreement (Kappa = 0.74) between the on-site glucometer and point-of-care HbA1c tests in detecting DM range of hyperglycemia. Conclusion The implementation of clinical-demographic markers and blood glucose screening identified the overall prevalence of DM and those at risk of DM in TB patients. Clinical-demographic markers are independent predictors for DM range hyperglycemia and highlight the importance of further diagnostic testing and early co-management of TB and DM.
Collapse
Affiliation(s)
- Kenneth Cleophace Byashalira
- Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania. .,Kibong'oto Infectious Diseases Hospital, Sanya Juu, P.O. Box: 12, Siha, Kilimanjaro, United Republic of Tanzania.
| | - Nyasatu Godfrey Chamba
- Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania.,Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania
| | - Yosra Alkabab
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, USA
| | - Peter Masunga Mbelele
- Kibong'oto Infectious Diseases Hospital, Sanya Juu, P.O. Box: 12, Siha, Kilimanjaro, United Republic of Tanzania
| | - Nyanda Elias Ntinginya
- National Institute of Medical Research, Mbeya Medical Research Centre, Mbeya, United Republic of Tanzania
| | | | - Mohamed Zahir Alimohamed
- Shree Hindu Mandal Hospital, Dar es Salaam, United Republic of Tanzania.,Department of Haematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, United Republic of Tanzania
| | - Scott Kirkland Heysell
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, USA
| | - Blandina Theophil Mmbaga
- Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania.,Kilimanjaro Christian Medical Centre, Moshi, United Republic of Tanzania.,Kilimanjaro Clinical Research Institute, Moshi, United Republic of Tanzania
| | - Ib Christian Bygbjerg
- Division Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Dirk Lund Christensen
- Division Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Stellah George Mpagama
- Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania.,Kibong'oto Infectious Diseases Hospital, Sanya Juu, P.O. Box: 12, Siha, Kilimanjaro, United Republic of Tanzania
| | - Troels Lillebaek
- Division Global Health Section, Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,International Reference Laboratory of Mycobacteriology, Statens Serum Institut, Copenhagen, Denmark
| | | |
Collapse
|
2
|
Mbelele PM, Sabiiti W, Heysell SK, Sauli E, Mpolya EA, Mfinanga S, Gillespie SH, Addo KK, Kibiki G, Sloan DJ, Mpagama SG. Use of a molecular bacterial load assay to distinguish between active TB and post-TB lung disease. Int J Tuberc Lung Dis 2022; 26:276-278. [PMID: 35197168 PMCID: PMC8886960 DOI: 10.5588/ijtld.21.0459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Affiliation(s)
- P M Mbelele
- Kibong´oto Infectious Diseases Hospital, Sanya Juu, Siha, Kilimanjaro, Tanzania, Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha, Tanzania
| | - W Sabiiti
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, Scotland, UK
| | - S K Heysell
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - E Sauli
- Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha, Tanzania
| | - E A Mpolya
- Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha, Tanzania
| | - S Mfinanga
- Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha, Tanzania, National Institute for Medical Research (NIMR), Muhimbili Center, Dar es salaam, Tanzania
| | - S H Gillespie
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, Scotland, UK
| | - K K Addo
- Department of Bacteriology, Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - G Kibiki
- Kibong´oto Infectious Diseases Hospital, Sanya Juu, Siha, Kilimanjaro, Tanzania, East African Health Research Commission (EAHRC), Bujumbura, Burundi
| | - D J Sloan
- Division of Infection and Global Health, School of Medicine, University of St Andrews, St Andrews, Scotland, UK
| | - S G Mpagama
- Kibong´oto Infectious Diseases Hospital, Sanya Juu, Siha, Kilimanjaro, Tanzania, Department of Global Health and Biomedical Sciences, School of Life Sciences and Bioengineering, Nelson Mandela African Institution of Science and Technology (NM-AIST), Arusha, Tanzania
| |
Collapse
|