Prevalence, Predictors and Treatment Outcome of Type 2 Diabetes among Newly Diagnosed Sputum Positive Pulmonary Tuberculosis Patients in Western Cameroon

Abstract

There is a growing awareness on a global scale on the possible relationship between tuberculosis (TB) and diabetes mellitus (DM). We conducted a prospective study in sputum positive pulmonary TB patients in two TB management clinics in Bamenda and Bafoussam in the North West and West regions of Cameroon respectively to determine the prevalence of type 2 diabetes, associated risk factors and the impact of diabetes in the treatment outcome. Of the 222 patients who participated in the study, 9.4% [21/222] were diabetic with age 21-70 years, 15.32% [34/222] had impaired glucose tolerance whereas 32.43% [72/222] had a family history of diabetes. Among the 21 patients who had diabetes, 20 had T2D (17 where newly diagnose whereas 3 were known T2D) and one had type 1 diabetes and was also newly diagnose. We noted a threefold increase in the risk of diabetes among unmarried TB patients and a 32% increase in the risk of diabetes for every unit increase in the body mass index (BMI). HIV Patients had a four-fold risk of being diabetic in our analysis. In conclusion the prevalence of DM among TB patients was found to be 9.4%. The principal risk factors associated with the DM among TB patients were BMI, unmarried and HIV infected. We observe no significant difference in sputum conversion at two month of treatment with 28.8% [6/21] TB with DM and 70.4% [95/136] TB without DM that are still positive after 2 months of treatment versus 57.1% [12/21] of TB with DM and 21.5% [29/136] TB without DM that pass from positive to negative after 2 months of treatment (P = 0.442). Whereas in the treatment outcome, there was a significant difference when comparing cured TB with DM (90%) and TB without DM (96.0%) (P = 0.04). Likewise we also noted a significant difference in treatment outcome when comparing treatment completion between TB patients with DM (90.0%) and TB patients without (97.6%) (P = 0.002).