Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: a systematic review and meta-analysis of observational studies

Animut Alebel; Amsalu Taye Wondemagegn; Cheru Tesema; Getiye Dejenu Kibret; Fasil Wagnew; Pammla Petrucka; Amit Arora; Amare Demsie Ayele; Mulunesh Alemayehu; Setegn Eshetie

doi:10.1186/s12879-019-3892-8

Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: a systematic review and meta-analysis of observational studies

BMC Infect Dis. 2019 Mar 13;19(1):254. doi: 10.1186/s12879-019-3892-8.

Authors

Affiliations

¹ College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia. animut.a23@gmail.com.
² College of Health Sciences, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
³ College of Nursing, University of Saskatchewan, Saskatoon, Canada.
⁴ School of Life Sciences and Bioengineering, Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania.
⁵ School of Science and Health, Western Sydney University, Penrith, NSW, 2751, Australia.
⁶ Translational Health Research Institute, Western Sydney University, Penrith, NSW, 2751, Australia.
⁷ Discipline of Child and Adolescent Health, Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, NSW, 2145, Australia.
⁸ Oral Health Services, Sydney Local Health District and Sydney Dental Hospital, NSW Health, Surry Hills, NSW, 2010, Australia.
⁹ College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Abstract

Background: Tuberculosis and diabetes mellitus are significant global public health challenges. In Sub-Saharan Africa, study findings regarding prevalence of diabetes mellitus amongst tuberculosis patients have been inconsistent and highly variable. Therefore, this systematic review and meta-analysis estimates the overall prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa.

Methods: Four international databases (PubMed, Google Scholar, Science Direct and Cochrane Library) were systematically searched. We included all observational studies reporting the prevalence of DM among TB patients in Sub-Saharan Africa. All necessary data for this review were extracted using a standardized data extraction format by two authors (CT and AA1). STATA Version 14 statistical software was employed to conduct meta-analysis. The Cochrane Q test statistics and I² test were used to assess the heterogeneity of the studies. Finally, a random effects meta-analysis model was computed to estimate the pooled prevalence of diabetes mellitus in TB patients. Besides, subgroup analysis was done based on different factors.

Results: In the meta-analysis, sixteen studies fulfilled the inclusion criteria and were included. The findings of these 16 studies revealed that the pooled prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa was 9.0% (95% CI: 6.0, 12.0%). The highest prevalence of diabetes mellitus among tuberculosis patients was found in Nigeria (15%), followed by Tanzania (11%), and then Ethiopia (10%). Besides, the prevalence of diabetes mellitus among HIV infected TB patients was (8.9%) which is slightly higher than HIV uninfected (7.7%) TB patients.

Conclusion: Diabetes mellitus among tuberculosis patients in Sub-Saharan Africa was significantly high. Moreover, this study found that there was a high prevalence of DM among HIV infected than uninfected TB patients. It is strongly recommended to screen for DM among TB patients and special emphasis should be given for early screening of DM among TB/HIV co-infected patients.

Keywords: Sub-Saharan Africa; Tuberculosis; Type1/type 2 diabetes mellitus.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Africa South of the Sahara / epidemiology
Diabetes Complications* / epidemiology
Humans
Observational Studies as Topic
Prevalence
Tuberculosis* / complications
Tuberculosis* / epidemiology