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TB infection in adults with diabetes mellitus in Uganda

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BACKGROUND: The diabetes mellitus (DM) and TB dual epidemic is growing in sub-Saharan Africa (SSA), yet the underlying mechanisms of increased TB risk in DM are incompletely understood. We determined the prevalence and factors associated with TB infection (TBI) among DM patients at a tertiary hospital outpatient clinic in Uganda.

METHODS: Eligible consenting adults were recruited for this cross-sectional study at an outpatient diabetes clinic using systematic random sampling. Data were collected using a pre-tested case report form. TBI was defined as a positive QuantiFERON® Gold Plus test (QFT-Plus) result. Factors associated with TBI were determined using modified Poisson regression analysis in Stata BE v.16.0.

RESULTS: Among the 185 study participants, over two thirds were female and 87.6% (n = 162) were receiving metformin therapy. More than two thirds (143/185) had poor glycaemic control. TBI prevalence was 57.8% (107/185). Concurrent calcium channel blocker (adjusted prevalence ratio [aPR] 1.33, 95% CI 1.05–1.69) and pregabalin therapies (aPR 1.45, 95% CI 1.15–1.84) were independently associated with TBI.

CONCLUSIONS: DM individuals on calcium channel blocker and pregabalin therapies should be routinely screened for TBI. Further studies should investigate the mechanisms of commonly used drugs for TBI in patients with DM in Uganda.

Keywords: Africa; DM; TBI; calcium channel blocker; cross-sectional study; glycaemic control; pregabalin

Document Type: Research Article

Affiliations: 1: School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda, Directorate of Programs, The AIDS Support Organisation (U) Ltd, Kampala, Uganda 2: Tuberculosis and Comorbidities Research Group, Makerere University, Kampala, Uganda 3: Tuberculosis and Comorbidities Research Group, Makerere University, Kampala, Uganda, Department of Molecular Biology and Immunology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala, Uganda 4: School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda 5: Department of Medicine, Lubaga Hospital, Kampala, Uganda 6: School of Medicine, College of Health Sciences, Makerere University, Kampala, Uganda, Tuberculosis and Comorbidities Research Group, Makerere University, Kampala, Uganda, Medical Research Council/Uganda Virus Research Institute & London School of Hygiene & Tropical Medicine Uganda Research Unit, Entebbe, Uganda

Publication date: April 1, 2023

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