Prevalence and associated factors of TB and diabetes mellitus comorbidity: A systematic review
Abstract
Introduction
The dual burden of
tuberculosis (TB) and diabetes mellitus (DM) has become a major
global public health concern. There is mounting evidence from
different countries on the burden of TB and DM comorbidity. The
objective of this systematic review was to summarize the
existing evidence on prevalence and associated/risk factors of
TBDM comorbidity at global and regional levels.
Methods
Ovid Medline, Embase, Global
health, Cochrane library, Web of science and Scopus Elsevier
databases were searched to identify eligible articles for the
systematic review. Data were extracted using standardized excel
form and pilot tested. Median with interquartile range (IQR) was
used to estimate prevalence of TBDM comorbidity. Associated/risk
factors that were identified from individual studies were
thematically analyzed and described.
Results
The prevalence of DM among
TB patients ranged from 1.9% to 45%. The overall median global
prevalence was 16% (IQR 9.0%-25.3%) Similarly, the prevalence of
TB among DM patients ranged from 0.38% to 14% and the overall
median global prevalence was 4.1% (IQR 1.8%-6.2%). The highest
prevalence of DM among TB patients is observed in the studied
countries of Asia, North America and Oceania. On the contrary,
the prevalence of TB among DM patients is low globally, but
relatively higher in the studied countries of Asia and the
African continents. Sex, older age, urban residence, tobacco
smoking, sedentary lifestyle, poor glycemic control, having
family history of DM and TB illness were among the variables
identified as associated/risk factors for TBDM comorbidity.
Conclusion
This systematic review
revealed that there is a high burden of DM among TB patients at
global level. On the contrary, the global prevalence of TB among
DM patients is low. Assessing the magnitude and risk/associated
factors of TBDM comorbidity at country/local level is crucial
before making decisions to undertake TBDM integrated services.
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Source:
PLOS ONE
