Prevalence and associated factors of tuberculosis among diabetic patients attending public health facilities in Ethiopia: a multicenter study

Abstract Background Individuals with diabetes mellitus (DM) have high tuberculosis (TB) prevalence. Currently, the incidence of DM is increasing in low and middle-income countries including Ethiopia where TB is also endemic, which may complicate TB prevention and control efforts. In this context, th...

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Main Authors: Ayinalem Alemu, Getachew Seid, Getu Diriba, Michael Hailu, Biniyam Dange, Shewki Moga, Daniel Melese, Gemechu Tadesse, Solomon H Mariam, Nega Berhe, Balako Gumi
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Archives of Public Health
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Online Access:https://doi.org/10.1186/s13690-025-01530-6
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author Ayinalem Alemu
Getachew Seid
Getu Diriba
Michael Hailu
Biniyam Dange
Shewki Moga
Daniel Melese
Gemechu Tadesse
Solomon H Mariam
Nega Berhe
Balako Gumi
author_facet Ayinalem Alemu
Getachew Seid
Getu Diriba
Michael Hailu
Biniyam Dange
Shewki Moga
Daniel Melese
Gemechu Tadesse
Solomon H Mariam
Nega Berhe
Balako Gumi
author_sort Ayinalem Alemu
collection DOAJ
description Abstract Background Individuals with diabetes mellitus (DM) have high tuberculosis (TB) prevalence. Currently, the incidence of DM is increasing in low and middle-income countries including Ethiopia where TB is also endemic, which may complicate TB prevention and control efforts. In this context, the prevalence and associated factors of TB among DM patients are not well understood in Ethiopia. This study assessed the prevalence of TB and associated factors among DM patients attending public health facilities in Ethiopia. Methods A multicenter cross-sectional study was employed from January to December 2023 among DM patients attending selected public health facilities in five regions of Ethiopia. The consecutive DM patients ≥ 15 years of age were screened for TB and those with signs and symptoms suggestive of TB were enrolled. Patient-related socio-demographic, behavioral, and clinical data were collected. Morning sputum and urine specimens were collected from each participant. Smear microscopy, culture, and Xpert MTB/RIF Ultra assay were conducted. Data were analyzed using SPSS version 27. Descriptive summary measures were computed to characterize the study variables. A logistic regression model was conducted to assess the statistical association between variables. Results In total,14,119 DM patients were screened for TB. Of them, 652 (4.62%) were found to have presumptive TB and were enrolled in the study. The mean age of enrolled participants was 55.47 years and 88.3% (576) had type II DM. Among them, 73 (11.2%, 95%CI = 8.7–13.5%) had TB which yielded a point prevalence of 517/100,000 among all screened DM patients. Bacteriological confirmation of TB occurred in 56 cases (8.6%, 95%CI = 6.4–10.6%). The independently associated factors were being younger age group (15–24 years; aOR; 10.98, 95%CI = 1.90-63.56, 25–34 years; aOR; 4.74, 95%CI = 1.12–20.13, 35–44 years; aOR; 5.70, 95%CI = 2.09–15.55, and 45–54 years; aOR; 2.68, 95%CI = 1.22–5.92), cough lasting ≥ two weeks (aOR; 2.73, 95%CI = 1.25–5.60), cigarette smoking (aOR; 7.50, 95%CI = 2.54–22.19), contact with a known TB case (aOR; 9.16, 95%CI = 2.83–29.70), HIV seropositivity (aOR; 4.40, 95%CI = 1.36–14.46), more than 10 years of DM follow-up (aOR; 4.87, 95%CI = 2.06–11.52), insulin medication (aOR; 3.00, 95%CI = 1.16–7.81), and FBS level > 126 mg/dl (aOR; 2.72, 95%CI = 1.26–5.89). Conclusion Diabetic patients attending public health facilities in Ethiopia had high TB prevalence. The prevalence of TB was higher among certain DM groups which implies the need for regular TB screening among those groups. The authors recommend the integration of TB screening practice into routine diabetic care.
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spelling doaj-art-73a34ee52a3143ea8f9365cdbfb41b7e2025-08-20T03:00:57ZengBMCArchives of Public Health2049-32582025-02-0183111510.1186/s13690-025-01530-6Prevalence and associated factors of tuberculosis among diabetic patients attending public health facilities in Ethiopia: a multicenter studyAyinalem Alemu0Getachew Seid1Getu Diriba2Michael Hailu3Biniyam Dange4Shewki Moga5Daniel Melese6Gemechu Tadesse7Solomon H Mariam8Nega Berhe9Balako Gumi10Ethiopian Public Health InstituteEthiopian Public Health InstituteEthiopian Public Health InstituteEthiopian Public Health InstituteEthiopian Public Health InstituteEthiopian Public Health InstituteEthiopian Public Health InstituteEthiopian Public Health InstituteAklilu Lemma Institute of Pathobiology, Addis Ababa UniversityAklilu Lemma Institute of Pathobiology, Addis Ababa UniversityAklilu Lemma Institute of Pathobiology, Addis Ababa UniversityAbstract Background Individuals with diabetes mellitus (DM) have high tuberculosis (TB) prevalence. Currently, the incidence of DM is increasing in low and middle-income countries including Ethiopia where TB is also endemic, which may complicate TB prevention and control efforts. In this context, the prevalence and associated factors of TB among DM patients are not well understood in Ethiopia. This study assessed the prevalence of TB and associated factors among DM patients attending public health facilities in Ethiopia. Methods A multicenter cross-sectional study was employed from January to December 2023 among DM patients attending selected public health facilities in five regions of Ethiopia. The consecutive DM patients ≥ 15 years of age were screened for TB and those with signs and symptoms suggestive of TB were enrolled. Patient-related socio-demographic, behavioral, and clinical data were collected. Morning sputum and urine specimens were collected from each participant. Smear microscopy, culture, and Xpert MTB/RIF Ultra assay were conducted. Data were analyzed using SPSS version 27. Descriptive summary measures were computed to characterize the study variables. A logistic regression model was conducted to assess the statistical association between variables. Results In total,14,119 DM patients were screened for TB. Of them, 652 (4.62%) were found to have presumptive TB and were enrolled in the study. The mean age of enrolled participants was 55.47 years and 88.3% (576) had type II DM. Among them, 73 (11.2%, 95%CI = 8.7–13.5%) had TB which yielded a point prevalence of 517/100,000 among all screened DM patients. Bacteriological confirmation of TB occurred in 56 cases (8.6%, 95%CI = 6.4–10.6%). The independently associated factors were being younger age group (15–24 years; aOR; 10.98, 95%CI = 1.90-63.56, 25–34 years; aOR; 4.74, 95%CI = 1.12–20.13, 35–44 years; aOR; 5.70, 95%CI = 2.09–15.55, and 45–54 years; aOR; 2.68, 95%CI = 1.22–5.92), cough lasting ≥ two weeks (aOR; 2.73, 95%CI = 1.25–5.60), cigarette smoking (aOR; 7.50, 95%CI = 2.54–22.19), contact with a known TB case (aOR; 9.16, 95%CI = 2.83–29.70), HIV seropositivity (aOR; 4.40, 95%CI = 1.36–14.46), more than 10 years of DM follow-up (aOR; 4.87, 95%CI = 2.06–11.52), insulin medication (aOR; 3.00, 95%CI = 1.16–7.81), and FBS level > 126 mg/dl (aOR; 2.72, 95%CI = 1.26–5.89). Conclusion Diabetic patients attending public health facilities in Ethiopia had high TB prevalence. The prevalence of TB was higher among certain DM groups which implies the need for regular TB screening among those groups. The authors recommend the integration of TB screening practice into routine diabetic care.https://doi.org/10.1186/s13690-025-01530-6Associated factorsDiabetes mellitusEthiopiaPrevalenceTubeculosis
spellingShingle Ayinalem Alemu
Getachew Seid
Getu Diriba
Michael Hailu
Biniyam Dange
Shewki Moga
Daniel Melese
Gemechu Tadesse
Solomon H Mariam
Nega Berhe
Balako Gumi
Prevalence and associated factors of tuberculosis among diabetic patients attending public health facilities in Ethiopia: a multicenter study
Archives of Public Health
Associated factors
Diabetes mellitus
Ethiopia
Prevalence
Tubeculosis
title Prevalence and associated factors of tuberculosis among diabetic patients attending public health facilities in Ethiopia: a multicenter study
title_full Prevalence and associated factors of tuberculosis among diabetic patients attending public health facilities in Ethiopia: a multicenter study
title_fullStr Prevalence and associated factors of tuberculosis among diabetic patients attending public health facilities in Ethiopia: a multicenter study
title_full_unstemmed Prevalence and associated factors of tuberculosis among diabetic patients attending public health facilities in Ethiopia: a multicenter study
title_short Prevalence and associated factors of tuberculosis among diabetic patients attending public health facilities in Ethiopia: a multicenter study
title_sort prevalence and associated factors of tuberculosis among diabetic patients attending public health facilities in ethiopia a multicenter study
topic Associated factors
Diabetes mellitus
Ethiopia
Prevalence
Tubeculosis
url https://doi.org/10.1186/s13690-025-01530-6
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