TY - JOUR
T1 - Tuberculosis and diabetes in Nigerian patients with and without HIV.
AU - Lawson, Lovett
AU - Muc, Magdalena
AU - Oladimeji, Olanrewaju
AU - Iweha, Chijioke
AU - Opoola, Blessing
AU - Abdurhaman, Saddiq T.
AU - Bimba, John S.
AU - Cuevas, Luis
PY - 2017/8/1
Y1 - 2017/8/1
N2 - Type 2 Diabetes mellitus (DM) and the Human Immunodeficiency Virus (HIV) increase the risk of Tuberculosis (TB). The frequency of DM among patients with TB with and without HIV is poorly documented in many LMIC. This was a cross-sectional hospital-based study in Abuja, Nigeria. Adults with presumptive TB were screened consecutively using sputum culture for TB and blood for HIV screening, Fasting Plasma Glucose (FPG) and glycolisated haemoglobin (HbA1c) for diagnosis. HbA1c was measured using the D-10 Haemoglobin Testing System and a point-of-care test (A1C Now+ system) for comparison. Patients were classified as having DM or pre-diabetes using the D-10 reference test. 410 individuals had TB culture, FPG and HbA1c results. Participants had a mean (SD) age of 37.8 (12.6) years and 217 (54.8%) were male. 113 (27.6%) patients were culture-positive, 62 (15.1%) had DM and 46 (11.2%) pre-diabetes. 184 (53.3%) participants were HIV-positive and 95 (51.6%) were on ART. Patients with pre-diabetes and DM were more likely to have TB (OR=1.94, 95%CI=0.01-3.74 and OR=2.39, 95%CI=1.35-4.24, respectively). After adjustment for HIV, age and sex, only DM was statistically associated with TB (AOR=3.10, 95%CI=1.62-5.94). HIV-negative patients with DM had higher risk of TB (AOR=4.32, 95%CI 1.57-11.92) than HIV-positive patients with DM (AOR=3.31, 95%CI 1.29-8.54), but the difference was not statistically significant. A1C Now+ HbA1c measurements correlated poorly with the D-10 HbA1c reference test. A high proportion of patients in Abuja have markers of DM and pre-diabetes at the time of TB diagnosis.
AB - Type 2 Diabetes mellitus (DM) and the Human Immunodeficiency Virus (HIV) increase the risk of Tuberculosis (TB). The frequency of DM among patients with TB with and without HIV is poorly documented in many LMIC. This was a cross-sectional hospital-based study in Abuja, Nigeria. Adults with presumptive TB were screened consecutively using sputum culture for TB and blood for HIV screening, Fasting Plasma Glucose (FPG) and glycolisated haemoglobin (HbA1c) for diagnosis. HbA1c was measured using the D-10 Haemoglobin Testing System and a point-of-care test (A1C Now+ system) for comparison. Patients were classified as having DM or pre-diabetes using the D-10 reference test. 410 individuals had TB culture, FPG and HbA1c results. Participants had a mean (SD) age of 37.8 (12.6) years and 217 (54.8%) were male. 113 (27.6%) patients were culture-positive, 62 (15.1%) had DM and 46 (11.2%) pre-diabetes. 184 (53.3%) participants were HIV-positive and 95 (51.6%) were on ART. Patients with pre-diabetes and DM were more likely to have TB (OR=1.94, 95%CI=0.01-3.74 and OR=2.39, 95%CI=1.35-4.24, respectively). After adjustment for HIV, age and sex, only DM was statistically associated with TB (AOR=3.10, 95%CI=1.62-5.94). HIV-negative patients with DM had higher risk of TB (AOR=4.32, 95%CI 1.57-11.92) than HIV-positive patients with DM (AOR=3.31, 95%CI 1.29-8.54), but the difference was not statistically significant. A1C Now+ HbA1c measurements correlated poorly with the D-10 HbA1c reference test. A high proportion of patients in Abuja have markers of DM and pre-diabetes at the time of TB diagnosis.
KW - Diabetes mellitus
KW - HIV
KW - Nigeria
KW - Pre-diabetes
KW - Tuberculosis
U2 - 10.1016/j.ijid.2017.06.014
DO - 10.1016/j.ijid.2017.06.014
M3 - Article
SN - 1201-9712
VL - 61
SP - 121
EP - 125
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -
