Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Apr 21;12(4):e0175925.
doi: 10.1371/journal.pone.0175925. eCollection 2017.

Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review

Mahteme Haile Workneh  1   2 , Gunnar Aksel Bjune  1 , Solomon Abebe Yimer  1   2   3   4
Affiliations

Prevalence and associated factors of tuberculosis and diabetes mellitus comorbidity: A systematic review

Mahteme Haile Workneh et al. PLoS One. .

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.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow diagram of searched articles.
TB: tuberculosis, DM: diabetes mellitus, MDR: multi drug resistance.
Fig 2
Fig 2. Map showing median prevalence of DM among TB patients by region.
(NB: There is only one study reported in Europe). IQR: Interquartile range (Source of the map: https://www.flickr.com/photos/blatantworld/5052373414#. Accessed March 20/2017).
Fig 3
Fig 3. Map showing median prevalence of TB among DM patients by region.
(NB: North America and Europe each reported only one study). IQR: Interquartile range (Source of the map: http://www.sawyoo.com/postpic/2015/02/what-are-the-7-seven-continents_118851.png. Accessed March 20/2017).
See this image and copyright information in PMC

References

    1. Syal K, Srinivasan A, Banerjee D. VDR, RXR, coronin-1 and interferon ɤ levels in PBMCs of type-2 diabetes patients: Molecular link between diabetes and tuberculosis. Ind J Clin Biochem. 2015; 30(3):323–328. - PMC - PubMed
    1. World Health Organization. Global tuberculosis report. 2016. Available at http://apps.who.int/iris/bitstream/10665/250441/1/9789241565394-eng.pdf?... Accessed Nov.18/2016
    1. International Diabetes Federation. Diabetes atlas. Seventh edition.2015. Available at: http://www.diabetesatlas.org/resources/2015-atlas.html. Accessed Feburary 03/2016.
    1. Jeon CY, Murray MB, Baker MA. Managing tuberculosis in patients with diabetes mellitus: why we care and what we know. Expert Rev. Anti Infect. Ther. 2012; 10(8):863–868. doi: 10.1586/eri.12.75 - DOI - PubMed
    1. Riza AL, Pearson F, Ugarte-Gil C, Alisjahbana B, Van de Vijver S, Panduru NM,et al. Clinical management of concurrent diabetes and tuberculosis and the implications for patient services. Lancet Diabetes Endocrinol. 2014; 2(9):740–753. doi: 10.1016/S2213-8587(14)70110-X - DOI - PMC - PubMed

Publication types