Bidirectional screening of Tuberculosis and Diabetes Mellitus patients in the Gandaki Province of Nepal, 2024

Abstract

Introduction: Nepal faces a rising burden of non-communicable diseases (NCDs), particularly diabetes. Tuberculosis patients face an increased risk of developing diabetes due to factors such as prolonged inflammation, medication side effects, and lifestyle changes during treatment. Diabetes patients have a heightened susceptibility to tuberculosis due to compromised immune function, making them more susceptible to infection. Active screening for both diseases is crucial for early diagnosis and reduce tuberculosis transmission and prevent the development of complications of diabetes. The study aims to determine the prevalence of tuberculosis among diabetes patients and diabetes among tuberculosis patients and its associated factors.

Methodology: The study design was hospital based quantitative cross-sectional study. Diabetes patients visiting Provincial Public Health Laboratory, Pokhara Academy of Health Sciences and Tuberculosis patients visiting Tuberculosis Treatment Center were reached as a respondent. Systematic random sampling was done. Genexpert was performed on sputum samples for diagnosis of tuberculosis. Random blood sugar and HbA1c was measured from blood samples to diagnose diabetes. Data analysis was performed using descriptive statistics, binary and multiple logistic regression analysis through SPSS ver.22.

Results: The prevalence of diabetes among tuberculosis patients was 12.20% and tuberculosis among diabetes patients was 14.40%. Age, co-morbid conditions and HIV status were found to be predictors having diabetes among tuberculosis patients whereas, education status and presence of TB symptoms were found to be predictors having tuberculosis among diabetes patients.

Conclusion: The study concludes that nearly one in tenth respondents had tuberculosis among diabetes patients and vice versa. Encourage diabetes patients to attend regular follow-up visits to monitor tuberculosis and tuberculosis patients for diabetes. The study contributes for the evidence-based policies and practices and helps to understand the necessity of integrated screening and management strategies to address the dual burden of tuberculosis and diabetes effectively.