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Tuberculosis and diabetes mellitus in the R epublic of K iribati: a case–control study
Author(s) -
Viney K.,
Cavanaugh J.,
Kienene T.,
Harley D.,
Kelly P. M.,
Sleigh A.,
O'Connor J.,
Mase S.
Publication year - 2015
Publication title -
tropical medicine and international health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.056
H-Index - 114
eISSN - 1365-3156
pISSN - 1360-2276
DOI - 10.1111/tmi.12462
Subject(s) - medicine , diabetes mellitus , odds ratio , tuberculosis , confidence interval , logistic regression , case control study , pathology , endocrinology
Objectives To better inform local management of TB –diabetes collaborative activities, we aimed to determine the prevalence of diabetes among persons with and without TB and to determine the association between TB and diabetes in K iribati, a P acific I sland nation. Methods We compared consecutively enrolled TB cases to a group of randomly selected community controls without evidence of TB . Diabetes was diagnosed by H b A 1c, and clinical and demographic data were collected. A tuberculin skin test was administered to controls. The chi‐square test was used to assess significance in differences between cases and controls. We also calculated an odds ratio, with 95% confidence intervals, for the odds of diabetes among cases relative to controls. Unweighted multivariate logistic regression was performed to adjust for the effects of age and sex. Results A total of 275 TB cases and 499 controls were enrolled. The diabetes prevalence in cases (101, 37%) was significantly greater than in controls (94, 19%) (adjusted odds ratio: 2.8; 95% CI 2.0–4.1). Fifty‐five percent (108) of all diabetic diagnoses were new; this proportion was higher among controls (64.8%) than cases (46.5%). Five patients with TB were screened to detect one patient with diabetes. Conclusions There is a strong association between TB and diabetes in K iribati and bidirectional screening should be conducted in this setting.