Burden and associated phenotypic characteristics of tuberculosis infection in adult Africans with diabetes: a systematic review

Article Authors: Davis Kibirige, Irene Andia-Biraro, Andrew Peter Kyazze, Ronald Olum, Felix Bongomin, Rose Mwanje Nakavuma, Phillip Ssekamatte, Reagan Emoru, Goretti Nalubega, Nyasatu Chamba, Kajiru Kilonzo, Sweetness Naftal Laizer, Lucy Elauteri Mrema, Willyhelmina Olomi, Lilian Tina Minja, Nyanda Elias Ntinginya, Issa Sabi, Philip C Hill, Lindsey Te Brake, Reinout van Crevel, Katrina Sharples, Julia Critchley

    • Abstract

    Diabetes mellitus (DM) increases the risk of developing tuberculosis infection (TBI). However, the evidence on the burden and phenotypic characteristics of TBI in African patients with DM is limited. This study aimed to determine the prevalence and characterisation of TBI in native African patients living with DM. We searched PubMed, EMBASE, and African Journals Online for original studies reporting information on the prevalence and characteristics of TBI in adult Africans with DM. A forest plot was used to describe the pooled prevalence estimate of TBI and the corresponding 95% confidence intervals (CI). Six studies conducted in four African countries involving 721 participants with DM were included in this systematic review. The pooled prevalence estimate of TBI was 40% (95% CI 20-60%, I2 = 98.52%, p < 0.001). Age ≥ 40 years and glycated haemoglobin levels independently predicted TBI positivity in patients with DM in three studies. Africans with DM have a high prevalence of TBI, especially those who are older or with poorly controlled diabetes. This justifies the need for studies to explore how to screen and manage TBI to avert the progression to active TB disease.

    Bibliographical metadata

    Volume 13
    Issue No. 1
    DOI https://doi.org/10.1038/s41598-023-47285-4
    Links https://pubmed.ncbi.nlm.nih.gov/37963989/
    Related Faculties/Schools
    Affiliation

    Davis Kibirige 1 2, Irene Andia-Biraro 3 4, Andrew Peter Kyazze 3 4, Ronald Olum 5, Felix Bongomin 6, Rose Mwanje Nakavuma 3, Phillip Ssekamatte 3, Reagan Emoru 3, Goretti Nalubega 3, Nyasatu Chamba 7 8, Kajiru Kilonzo 7 8, Sweetness Naftal Laizer 7 8, Lucy Elauteri Mrema 9, Willyhelmina Olomi 9, Lilian Tina Minja 9, Nyanda Elias Ntinginya 9, Issa Sabi 9, Philip C Hill 10, Lindsey Te Brake 11, Reinout van Crevel 12 13, Katrina Sharples 10, Julia Critchley 14

    1 Department of Medicine, Uganda Martyrs’ Hospital Lubaga, Kampala, Uganda. kibirigedavis@gmail.com.
    2 Clinical Research Unit, Tuberculosis and Comorbidities Consortium, Kampala, Uganda. kibirigedavis@gmail.com.
    3 Clinical Research Unit, Tuberculosis and Comorbidities Consortium, Kampala, Uganda.
    4 Department of Medicine, Makerere University College of Health Sciences, Kampala, Uganda.
    5 Department of Medicine, St. Francis Hospital Nsambya, Kampala, Uganda.
    6 Department of Medical Microbiology and Immunology, Faculty of Medicine, Gulu University, Gulu, Uganda.
    7 Department of Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
    8 Department of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
    9 National Institute for Medical Research-Mbeya Medical Research Centre, Mbeya, Tanzania.
    10 Centre for International Health, Otago University, Dunedin, New Zealand.
    11 Department of Pharmacy, Radboud Institute for Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
    12 Department of Internal Medicine and Radboud Centre for Infectious Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.
    13 Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
    14 Population Health Research Institute, St. George’s University of London, London, UK.