Background
The diabetes (DM) burden is growing in countries wh
ere tuberculosis and HIVB1 remain
major challenges, threatening tuberculosis control
efforts. This study determined the
association between tuberculosis and diabetes / imp
aired glucose regulation (IGR) in the
context of HIVB1.
Methods
A crossBsectional study was conducted at a TB clini
c in Cape Town. Participants were
screened for DM and IGR, using fasting plasma gluco
se, oral glucose tolerance test and
HbA1c.
Results
414 TB and 438 nonBTB participants were enrolled. I
n multivariable analysis, diabetes was
associated with tuberculosis (Odds ratio: 2.4; 95%
CI 1.3 – 4.3 p=0.005); with 14%
population attributable risk fraction. but this ass
ociation varied by diagnostic test (driven by
HbA1c). The association remained significant in HI
VB1Binfected (Odds ratio: 2.4; 95% CI
1.1 – 5.2; p=0.030). A high prevalence of IGR (65.2
% amongst tuberculosis cases) and a
significant association with tuberculosis (Odds rat
io: 2.3; 95% CI: 1.6 – 3.3; p<0.001) was
also found.
Conclusions
Diabetes and IGR prevalence was high and associated
with tuberculosis, particularly in HIVB
1Binfected persons, highlighting the importance of
DM screening. The variation in findings
by diagnostic test highlights the need for better g
lycaemia markers to inform screening in the
context of tuberculosis and HIVB1.