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Tuberculosis and diabetes in Nigerian patients with and without HIV.

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Lawson, Lovett, Muc da Encarnacao, Magdalena, Oladimeji, Olanrewaju, Iweha, Chijioke, Opoola, Blessing, Abdurhaman, Saddiq, Bimba, John D and Cuevas, Luis ORCID: https://orcid.org/0000-0002-6581-0587 (2017) 'Tuberculosis and diabetes in Nigerian patients with and without HIV.'. International Journal of Infectious Diseases, Vol 61, pp. 121-125.

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Abstract

Type 2 Diabetes mellitus (DM) and the Human Immunodeficiency Virus (HIV) increase the risk of Tuberculosis (TB). The frequency of DM among patients with TB with and without HIV is poorly documented in many LMIC. This was a cross-sectional hospital-based study in Abuja, Nigeria. Adults with presumptive TB were screened consecutively using sputum culture for TB and blood for HIV screening, Fasting Plasma Glucose (FPG) and glycolisated haemoglobin (HbA1c) for diagnosis. HbA1c was measured using the D-10 Haemoglobin Testing System and a point-of-care test (A1C Now+ system) for comparison. Patients were classified as having DM or pre-diabetes using the D-10 reference test. 410 individuals had TB culture, FPG and HbA1c results. Participants had a mean (SD) age of 37.8 (12.6) years and 217 (54.8%) were male. 113 (27.6%) patients were culture-positive, 62 (15.1%) had DM and 46 (11.2%) pre-diabetes. 184 (53.3%) participants were HIV-positive and 95 (51.6%) were on ART. Patients with pre-diabetes and DM were more likely to have TB (OR=1.94, 95%CI=0.01-3.74 and OR=2.39, 95%CI=1.35-4.24, respectively). After adjustment for HIV, age and sex, only DM was statistically associated with TB (AOR=3.10, 95%CI=1.62-5.94). HIV-negative patients with DM had higher risk of TB (AOR=4.32, 95%CI 1.57-11.92) than HIV-positive patients with DM (AOR=3.31, 95%CI 1.29-8.54), but the difference was not statistically significant. A1C Now+ HbA1c measurements correlated poorly with the D-10 HbA1c reference test. A high proportion of patients in Abuja have markers of DM and pre-diabetes at the time of TB diagnosis.

Item Type: Article
Subjects: WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503 Acquired immunodeficiency syndrome. HIV infections
WC Communicable Diseases > Virus Diseases > Acquired Immunodeficiency Syndrome. HIV Infections > WC 503.5 Complications
WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
WK Endocrine System > WK 810 Diabetes mellitus
WK Endocrine System > WK 840 Diabetes as a complication in other conditions
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI): https://doi.org/10.1016/j.ijid.2017.06.014
SWORD Depositor: JISC Pubrouter
Depositing User: JISC Pubrouter
Date Deposited: 20 Jul 2017 09:48
Last Modified: 06 Feb 2018 13:15
URI: https://archive.lstmed.ac.uk/id/eprint/7349

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