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
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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.
Adults, Communities, Pre-diabetes, Latent Tuberculosis Infection, Risk Factors
To cite this article
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. doi: 10.11648/j.iji.20190702.11
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