Diabetes mellitus is associated with an increased risk of unsuccessful treatment outcomes among drug-susceptible tuberculosis patients in Ethiopia: A prospective health facility-based study

• Type of Material: Article
• Authors: Matthew Magee, Emory University; Rawleigh Howe, Emory University; HT Adane, Armauer Hansen Research Institute; L Wassie, Armauer Hansen Research Institute
• Language: English
• Date: 2023-05-01
• Publisher: Elsevier Inc
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Author(s)
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jctube.2023.100368
• Title of Journal or Parent Work: Journal of Clinical Tuberculosis and Other Mycobacterial Diseases
• Volume: 31
• Start Page: 100368
• End Page: 100368
• Grant/Funding Information: This research project was supported by an NIH Fogarty International Center Global Infectious Diseases grant (D43TW009127) through the Ethiopia-Emory Tuberculosis-Research Training Program (EETB-RTP). The EETB-RTP represents collaboration between Emory University, Addis Ababa University, the Armauer Hansen Research Institute (AHRI), and the Ethiopian Public Health Institute (EPHI).
• Keywords: Diabetes mellitus; Tuberculosis; Treatment outcomes
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Background: The impact of diabetes mellitus on tuberculosis (TB) treatment outcomes has not been well investigated in most sub-Saharan countries including Ethiopia. The current study aimed to determine the association between diabetes mellitus and unsuccessful TB treatment outcomes among drug-susceptible TB patients treated at selected health facilities in Addis Ababa, Ethiopia. Methods: This health facility-based prospective cohort study was conducted at six randomly selected public health centers in Addis Ababa, from August 2020 until November 2021. Clinically diagnosed adult pulmonary and extra pulmonary TB patients were recruited at the time of treatment initiation. A multivariable logistic regression analysis was used to estimate the association between diabetes and unsuccessful TB treatment outcomes. Results: Among the total 267 enrolled participants, 9.7% of patients with TB were identified to have diabetes comorbidity. Of patients with diabetes and TB, 9 (34.6%) were newly diagnosed based on glucose test results. Despite an overall high TB treatment success rate (94.0%), more than one-fourth (26.9%) of patients with diabetes had a poor TB treatment outcome (26.9%), which was remarkably higher compared to patients without diabetes (3.7%). In multivariable regression, the adjusted odds of poor TB treatment outcome among those with diabetes was 14.8 (95% CI 3.5 – 62.7) times the odds of poor outcome patients without diabetes. Conclusion: Diabetes was significantly associated with increased odds of poor TB treatment outcomes among patients in Addis Ababa, Ethiopia.