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


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

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