Prevalence and clinical features of tuberculosis in Ethiopian diabetic patients

Objective: To determine the prevalence and clinical characteristics of tube rculosis (TB) in diabetic patients. Design: This study was a cross-sectional survey based on the retrospective analysis of data on tuberculosis in diabetic patients. Settings: The study was conducted at Endocrinology and Metabolism Unit of t he Department of Internal Medicine, Faculty of:Medicine, Addis Ababa, Ethio pia, Subjects: Seventy eight cases of tuberculosis! among 1352 diabetic patients were included from September 1989 to 1996. Main outcome measures: Clinical evaluation, chest x-ray, acid fast bacilli (AFB) in sputum or measures tissue and histopathologic characteristic of bi opsy specimens. Results: Seventy eight cases of TB were identified among 1352 diabetic pati ents giving a prevalence of 5.8%. Among 1352 diabetic patients, 713 (52.7%) were males, 639 (43.3%) were females, 619 (45.8%) were IDDM and 733 (54.2% ) were NIDDM. The mean age of the 71 TB patients whose records could be ret rieved was 34.0+/-11.9 years, 42(59%) were males, 29 (41%) were females. Fi fty four (76.1%),were IDDM and 17 (23.9%) were NIDDM, 17 of the IDDM had cl inical characteristics of malnutrition-related diabetes mellitus (MRDM), 36 (56%) of 71 patients were admitted for management, The three most common s ymptoms of tuberculosis were fever (80.5%), sweating (80.4%) and cough (70. 5%). Twenty six (35.6%) of 71 cases were positive for AFB and six (8.5%) we re seropositive for HIV. Fifty six (78.9%) had pulmonary, eight (11.2%) had extrapulmonary and seven (9.8%) had disseminated TB. Forty eight off 53 ab normal chest x-ray showed unilateral involvement. Thirty eight of 41 (53.6% ) had completed TB treatment, relapse occurred in seven (9.8%), eight (11.2 %) are currently on treatment, 13 (18.3%) were lost to follow up, four (5.6 %) defaulted and three (4.2%) died. The relative risk of developing TB in I DDM and NIDDM patients Was being 26 times and seven times than the general population respectively. Conclusion: The prevalence of tuberculosis in the diabetic population is hi gh and this warrants a prospective study to determine association between p ulmonary tuberculosis and diabetes.