Incidence and predictors of tuberculosis among adult diabetes mellitus patients in western Amhara comprehensive specialized hospitals, northwest Ethiopia. A multicenter retrospective follow-up study.

BACKGROUND

Tuberculosis (TB) is a leading cause of morbidity and mortality worldwide, and Ethiopia is among the 30 high TB-burden countries. People with diabetes mellitus (DM) have a 2-3 times higher risk of developing TB than those without DM. However, the incidence and predictors of TB among adults with DM in the western Amhara region remain unclear. This study aimed to determine the incidence rate and predictors of TB among adult DM patients.

METHODS

A multi-center, institution-based retrospective follow-up study was conducted among 750 adult DM patients. Bivariate and multivariate Cox proportional hazards models were used to identify predictors of TB. Variables with a p-value < 0.05 in the multivariate analysis were considered independent predictors..

RESULTS

Among 750 participants, 67 (8.9%) developed TB, with an incidence rate of 27 per 1,000 person-years of observation (95% CI: 17.8-28.8). Significant predictors of TB included body mass index (BMI) < 18.5 kg/m2 (AHR = 1.87; 95% CI: 1.00-3.47), HIV positivity (AHR = 4.71; 95% CI: 2.68-8.26), cancer (AHR = 4.37; 95% CI: 1.54-12.39), chronic obstructive pulmonary disease (COPD) (AHR = 2.53; 95% CI: 1.23-5.21), and a history of close contact with TB patients (AHR = 6.53; 95% CI: 3.15-13.51)..

CONCLUSION

The incidence of TB among adult DM patients in western Amhara is high. Low BMI, HIV infection, cancer, COPD, and close contact with TB patients are significant predictors of TB in this population.