TB-Diabetes Co-Morbidity in Ghana: The Importance of Mycobacterium Africanum Infection
Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
PLOS
Abstract
Background
Diabetes Mellitus (DM) is a known risk factor for tuberculosis (TB) but little is known on TBDiabetes
Mellitus (TBDM) co-morbidity in Sub-Saharan Africa.
Methods
Consecutive TB cases registered at a tertiary facility in Ghana were recruited from September
2012 to April 2016 and screened for DM using random blood glucose and glycated
hemoglobin (HbA1c) level. TB patients were tested for other clinical parameters including
HIV co-infection and TB lesion location. Mycobacterial isolates obtained from collected sputum
samples were characterized by standard methods. Associations between TBDM
patients’ epidemiological as well as microbiological variables were assessed.
Results
The prevalence of DM at time of diagnosis among 2990 enrolled TB cases was 9.4% (282/
2990). TBDM cases were significantly associated with weight loss, poor appetite, night
sweat and fatigue (p<0.001) and were more likely (p<0.001) to have lower lung cavitation
85.8% (242/282) compared to TB Non-Diabetic (TBNDM) patients 3.3% (90/2708). We
observed 22.3% (63/282) treatment failures among TBDM patients compared to 3.8% (102/
2708) among TBNDM patients (p<0.001). We found no significant difference in the TBDM
burden attributed by M. tuberculosis sensu stricto (Mtbss) and Mycobacterium africanum
(Maf) and (Mtbss; 176/1836, 9.6% and Maf; 53/468, 11.3%, p = 0.2612). We found that diabetic
individuals were suggestively likely to present with TB caused byM. africanum Lineage
6 as opposed to Mtbss (odds ratio (OR) = 1.52; 95% confidence interval (CI): 0.92–2.42, p =
0.072). Conclusion
Our findings confirms the importance of screening for diabetes during TB diagnosis and
highlights the association between genetic diversity and diabetes in Ghana.
Description
Research Article
Keywords
co-morbidity, Mycobacterium africanum, TB-diabetes
Citation
Asante-Poku A, Asare P, Baddoo NA, Forson A, Klevor P, Otchere ID, et al. (2019) TBdiabetes co-morbidity in Ghana: The importance of Mycobacterium africanum infection. PLoS ONE 14 (2): e0211822. https://doi.org/10.1371/journal. pone.0211822