P Owiti1,2, A Keter1, A D Harries2,3, S Pastakia4,5, C Wambugu6, N Kirui1,7, G Kasera6, R Momanyi7, E Masini6, F Some1,5, A Gardner1,5,8,9. 1. Academic Model Providing Access to Healthcare (AMPATH), Eldoret, Kenya. 2. International Union Against Tuberculosis and Lung Disease, Paris, France. 3. London School of Hygiene & Tropical Medicine, London, UK. 4. Purdue University College of Pharmacy, West Lafayette, Indiana, USA. 5. Moi University School of Medicine, Eldoret, Kenya. 6. Ministry of Health, Nairobi, Kenya. 7. Moi Teaching and Referral Hospital, Eldoret, Kenya. 8. Alpert Medical School, Brown University, Providence, Rhode Island, USA. 9. Indiana University School of Medicine, Bloomington, Indiana, USA.
Abstract
Setting: The tuberculosis (TB) clinics of five health facilities in western Kenya. Objective: To assess the prevalence and associated determinants of diabetes mellitus (DM) and pre-diabetes hyperglycaemia among adult TB patients using point-of-care DCA Vantage glycated haemoglobin (HbA1c) devices. Design: This was a cross-sectional study. Results: Of 454 patients, 272 (60%) were males, the median age was 34 years, 175 (39%) were co-infected with the human immunodeficiency virus (HIV), and the median duration of anti-tuberculosis treatment was 8 weeks; 180 (40%) patients reported at least one classical symptom suggestive of DM. The prevalence of DM (HbA1c ⩾6.5%) was 5.1% (95%CI 3.2-7.5), while that of pre-diabetes (HbA1c 5.7-6.4%) was 37.5% (95%CI 33.1-42.2). The number needed to screen (NNS) was 19.6 for DM and 2.7 for pre-diabetes. Combined, 42.6% (95%CI 38.0-47.3) of the patients had either pre-diabetes or DM (NNS 2.3). Seven of the 23 patients with DM knew their prior DM status. Higher rates of DM were associated with age ⩾40 years and a family history of DM, but not obesity, type of TB, HIV status or suggestive symptoms. Conclusions: High rates of pre-diabetes and DM were found in adult TB patients. This study supports the need for routine screening of all patients with TB for DM in Kenya.
Setting: The tuberculosis (TB) clinics of five health facilities in western Kenya. Objective: To assess the prevalence and associated determinants of diabetes mellitus (DM) and pre-diabetes hyperglycaemia among adult TB patients using point-of-care DCA Vantage glycated haemoglobin (HbA1c) devices. Design: This was a cross-sectional study. Results: Of 454 patients, 272 (60%) were males, the median age was 34 years, 175 (39%) were co-infected with the human immunodeficiency virus (HIV), and the median duration of anti-tuberculosis treatment was 8 weeks; 180 (40%) patients reported at least one classical symptom suggestive of DM. The prevalence of DM (HbA1c ⩾6.5%) was 5.1% (95%CI 3.2-7.5), while that of pre-diabetes (HbA1c 5.7-6.4%) was 37.5% (95%CI 33.1-42.2). The number needed to screen (NNS) was 19.6 for DM and 2.7 for pre-diabetes. Combined, 42.6% (95%CI 38.0-47.3) of the patients had either pre-diabetes or DM (NNS 2.3). Seven of the 23 patients with DM knew their prior DM status. Higher rates of DM were associated with age ⩾40 years and a family history of DM, but not obesity, type of TB, HIV status or suggestive symptoms. Conclusions: High rates of pre-diabetes and DM were found in adult TB patients. This study supports the need for routine screening of all patients with TB for DM in Kenya.
Authors: Christie Y Jeon; Anthony D Harries; Meghan A Baker; Jessica E Hart; Anil Kapur; Knut Lönnroth; Salah-Eddine Ottmani; Sunali Goonesekera; Megan B Murray Journal: Trop Med Int Health Date: 2010-09-24 Impact factor: 2.622
Authors: Chi C Leung; Tai H Lam; Wai M Chan; Wing W Yew; Kin S Ho; Gabriel M Leung; Wing S Law; Cheuk M Tam; Chi K Chan; Kwok C Chang Journal: Am J Epidemiol Date: 2008-04-08 Impact factor: 4.897
Authors: S Ade; D Affolabi; G Agodokpessi; P Wachinou; F Faïhun; N Toundoh; W Békou; A Makpenon; G Ade; S Anagonou; A D Harries Journal: Public Health Action Date: 2015-06-21
Authors: Michael Tirwomwe; Isaac Echoru; Richard Maseruka; Kyobe Ronald Kimanje; Wilson Byarugaba Journal: Evid Based Complement Alternat Med Date: 2019-09-19 Impact factor: 2.629
Authors: Susanne F Awad; Peijue Huangfu; Houssein H Ayoub; Fiona Pearson; Soha R Dargham; Julia A Critchley; Laith J Abu-Raddad Journal: J Glob Health Date: 2019-12 Impact factor: 4.413
Authors: Patrick L Mabula; Kelly I Kazinyingia; Edwin Christian Chavala; Victor Mosha; Sia E Msuya; Beatrice John Leyaro Journal: East Afr Health Res J Date: 2021-06-11
Authors: Clare Eckold; Vinod Kumar; January Weiner; Bachti Alisjahbana; Anca-Lelia Riza; Katharina Ronacher; Jorge Coronel; Sarah Kerry-Barnard; Stephanus T Malherbe; Leanie Kleynhans; Kim Stanley; Rovina Ruslami; Mihai Ioana; Cesar Ugarte-Gil; Gerhard Walzl; Reinout van Crevel; Cisca Wijmenga; Julia A Critchley; Hazel M Dockrell; Jacqueline M Cliff Journal: Clin Infect Dis Date: 2021-01-23 Impact factor: 9.079