Prevalence and Determinants of Pre-diabetes and Latent Tuberculosis Infection Among Apparently Healthy Adults in Three Communities in Southern Nigeria
International Journal of Immunology
Volume 7, Issue 2, June 2019, Pages: 23-32
Received: Jul. 3, 2019;
Accepted: Jul. 26, 2019;
Published: Aug. 14, 2019
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Benson Olu Akinshipe, Departments of Medical Microbiology, School of Clinical Medicine, Igbinedion University & Igbinedion University Teaching Hospital, Okada, Nigeria
Edirin Omorigho Yusuf, Department of Medical Microbiology, School of Clinical Medicine, University of Benin/Teaching Hospital, Benin City, Nigeria
Felix Oladapo Akinshipe, Department of Internal Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria
Muyiwa Adeleye Moronkeji, Department of Chemical Pathology, Ladoke Akintola University of Technology Teaching Hospital, Oshogbo, Nigeria
Anthony Chukwuka Nwaobi, Department of Medical Laboratory Science, Igbinedion University, Okada, Nigeria
Type 2 diabetes mellitus (DM) is commonly associated with pulmonary tuberculosis (TB) and vice versa. Although most individuals with DM and TB pass through intermediate state of pre-diabetes mellitus (PDM) and latent tuberculosis infection (LTBI) respectively, however, data is scant on PDM and LTBI in co-endemic populations to inform recommendations on intervention in those settings. This study aimed to assess the prevalence of PDM and LTBI and determine the susceptibility factors among presumably low- risk adults in a high DM-and TB setting. A cross-sectional study of 352 able-bodied adults was conducted in three communities representative of the southern Nigeria population. Socio-demographic and anthropometric data of the participants were collected using a modified WHO STEPS Wise instrument. A single random blood sample was used to measure glycated hemoglobin (HbA1c) using Cobas c111 Auto-analyzer and interferon-gamma (INF-γ) production with the aid of Quantiferon TB-Gold-In Tube (QFT-GIT) kit. Pre-diabetes was defined as HbA1c between 5.7-6.4% and LTBI as INF- γ positivity (≥0.35 IU/ml). Overall, the prevalence of PDM was 29 (8.2%) (95% CI: 6.4-9.4%) and LTBI 83 (23.6%) (95% CI: 21.6-27.3%), while 9 (2.6%) had dual PDM-LTBI. The urbanites recorded higher PDM 15 (12.8%) (X2=6.340, p=0.022) whereas LTBI was higher among villagers 48 (43.6%) (X2=36.503, p=0.0001). Risk factors associated with PDM and LTBI were: residence status, aging, smoking, familial DM and non-BCG vaccination. Aging was the single most important predictor of PDM (X2=8.469, p=0.007), LTBI (X2=59.541, p=0.001); with aged 50-59 years having four-fold higher risk of PDM-LTBI (OR=4.72, 95% CI=3.25; p=0.0001). These findings indicate that one in twelve and one in four presumably healthy persons screened were found to harbor PDM and LTBI respectively. There is a twin epidemic of PDM and LTBI among southern Nigeria adults. Susceptibility pattern suggests environmental, familial and cumulative life-time risks. ‘Syndemic’ DM and TB in the area is imminent in the absence of timeous intervention.
Benson Olu Akinshipe,
Edirin Omorigho Yusuf,
Felix Oladapo Akinshipe,
Muyiwa Adeleye Moronkeji,
Anthony Chukwuka Nwaobi,
Prevalence and Determinants of Pre-diabetes and Latent Tuberculosis Infection Among Apparently Healthy Adults in Three Communities in Southern Nigeria, International Journal of Immunology.
Vol. 7, No. 2,
2019, pp. 23-32.
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