| Peer-Reviewed

Prevalence and Determinants of Pre-diabetes and Latent Tuberculosis Infection Among Apparently Healthy Adults in Three Communities in Southern Nigeria

Received: 3 July 2019    Accepted: 26 July 2019    Published: 14 August 2019
Views:       Downloads:
Abstract

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.

Published in International Journal of Immunology (Volume 7, Issue 2)
DOI 10.11648/j.iji.20190702.11
Page(s) 23-32
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Adults, Communities, Pre-diabetes, Latent Tuberculosis Infection, Risk Factors

References
[1] Firanescu A-G, Popa A, Sandu M-M, Protasiewicz DA, Popa SG, Mota M. The global prevalence and incidence of diabetes mellitus and pulmonary tuberculosis. Roma J Diabetes Nutr Metab Dis 2016; 23 (3): 319-326.
[2] Viswanathan V, Kumpatla S, Aravindalochanan V et al. Prevalence of diabetes and prediabetes and associated risk factors among tuberculosis patients in India. PLoS One. e41367. doi: 10.371/journal. pone.0041367. 2012; 7.
[3] Dooley KE, Chaisson RE. Tuberculosis and diabetes mellitus: convergence of two epidemics. Lancet Infect Dis. 2009; 9: 937-74.
[4] Dixon B. Diabetes and tuberculosis: an unhealthy partnership. Lancet Infect. Dis 2007; 7: 444.
[5] Harries AD, Satyanarayana S, Kumar AMV et al. Epidemiology and interaction of diabetes mellitus and tuberculosis and challenges for care: a review. Public Health Action. doi: 10.5588/pha. 130024 PMID: 26393066. 2013; l3 [Suppl. 1] S3-S9.
[6] WHO / IUATLD Collaborative Framework for Care and Control of Tuberculosis and Diabetes. Geneva, Switzerland: WHO, 2011; WHO/HTM/TB/2011.15.
[7] Chatterjee R, Narayan KMV, Lipscomb J et al. Screening for diabetes and pre-diabetes should be cost-saving in patients at high risk. Diabetes Care. 2013; 36 (7): 1981-7.
[8] Petur Petursson. Aspects of Abnormal Glucose Regulation in Various Manifestations of Coronary Artery Disease. Coronary Artery Disease 2013; 24 (7): 577-582.
[9] Podell BK, Ackart DF, Kirk NM, Eck SP, Bell C, Basaraba RJ. Non-diabetic hyperglycemia exacerbates disease severity in Mycobacterium tuberculosis infected guinea pig. PLoS One. e46824. PubMed 23056469. 2012; 7.
[10] Tabak AG, Herder C, Rathman W, Brunner EJ, Kivimaki M. Prediabetes: A high-risk state for developing diabetes. Lancet. 2012; 379 (9833): 2279-2290.
[11] World Health Organization, International Diabetic Federation. Definition and diagnosis of diabetes mellitus and intermediate hyperglycemia: a report of a WHO/IDF Consultation. Geneva: WHO. 2006.
[12] The American Diabetic Association, European Association for the Study of Diabetes, International Federation of Clinical Chemistry and Laboratory Medicine and the International Diabetes Federation Consensus Statement on Worldwide Standardization of the Haemoglobin A1c Measurement. Diabetes Care. 2007; 30: 2399-400.
[13] Heianza Y, Hara S, Arase Y et al. HbA1c 5.7-6.4% and impaired fasting plasma glucose for diagnosis of prediabetes and risk of progression to diabetes in Japan (TOPICS): a longitudinal cohort study. Lancet. 2011; 378: 147-155.
[14] Anjana RM, Shanthi Ram CS, Deepa M et al, Incidence of diabetes and pre-diabetes and predictors of progression among Asian Indians: 10-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES). Diabetes Care. 2015; 38: 1441-1448.
[15] Almeida-Junior JL, Gil-Santana L, Oliveira CAM et al. Glucose metabolism disorder is associated with pulmonary tuberculosis in individuals with respiratory symptoms from Brazil. PLoS One. 2016; 11: 1-14.
[16] World Health Organization. Global Tuberculosis Report 2016. http://www.who.int/tb/publications/global_report.
[17] Vynnycky E, Fine PE. Lifetime risks, incubation period, and serial interval of tuberculosis. Amer J Epidemiol. 152: 247-263.
[18] Mazurek GH, Jereb J, Vernon A et al. CDC updated guidelines for using Interferon gamma release assay to detect Mycobacterium tuberculosis infection—United States, 2010. MMWR Recommd. Rep. 2010; 59: 1-25.
[19] Diabetes Atlas Eight Edition Committee. IDF Diabetes Atlas: Brussels, Belgium: International Diabetes Federation. http://www.diabetesatlas.org/resources/2017.atlas.html. 2017.
[20] Global Tuberculosis Control 2018, WHO, Geneva. Use of high burden country list for TB by WHO in post-2015 era. https//www,who.int/tb/publications /global_report/en/. 2018.
[21] Adeloye D, Ige JO, Aderemi AV et al. Estimating the prevalence, hospitalization and mortality from type 2 diabetes mellitus in Nigeria: a systematic Review and Meta-analysis. BMJ Open. e015424. doi: 10.2017; 7.
[22] Nigeria Bureau of Statistics. Annual Abstract of Statistics 2016-Proshare [cited July 19, 2017]. https://www.proshareng.com/news/General/NBS-Annual-Absract-of-statistics....-/35588.
[23] Nigeria Diabetes Association Guidelines 2018. Published by the Diabetes Association of Nigeria. https//www.idf.org/our-network/regions-members/Africa.
[24] Nigeria National Tuberculosis and Leprosy and Buruli Ulcer Control Program (NTBLCP), National Strategic Plan-TB 2015-2020.
[25] World Health Organization. WHO STEPS Surveillance Manual. The WHO STEP Wise Approach to Chronic Disease Risk Factor Surveillance. Geneva, Switzerland. http://ww.whqlipdoc.who.int/publications/2005/9241593830-eng.pdf. 2005.
[26] Meme N, Amwayi S, Nganga Z, Buregyeya E. Prevalence of undiagnosed diabetes and pre-diabetes among hypertensive patients attending Kiambu district Hospital, Kenya: a cross-sectional study. Pan African Medical Journal. doi: 10.11604/pamj.2015.22.286.73. 2015; 22: 286.
[27] Ayah R, Joshi MD, Wanjiru R et al. A population-based survey of prevalence of diabetes and correlates in an urban slum in Nairobi, Kenya. BMC Public Health. 2013; 13: 371.
[28] Roche Cobas c111 User Manual. https://www.scribd.com/doc /9125231/Roche-cobas c111-user-Manual.
[29] Quantiferon-TB Gold (in-tube method). Package insert. www.Cellestis.com/IRM/company/show page. aspx (cpin-1177). 2013.
[30] Akinshipe BO, Ezeani PC, Digban KA, Ehiaghe FA, Adedeji EB, Ehiaghe JI. Immunodiagnostic Potential of an In-vitro Interferon-Gamma Release Assay for Latent Tuberculosis Infection among Apparently Healthy Individuals in Okada Community, Nigeria. Int J Immunol. 2017; 5 (3): 41-48.
[31] Miri-Dashe T, Osewe S, Tokdung M et al. Comprehensive reference ranges for hematology and clinical chemistry parameters derived from normal Nigerian adults. PLoS One. doi: 10.1371/journal. pone, 0093919. 2014; 9 (5): 939.
[32] Rasaki SO, Kasali FO, Biliaminu SA, Odeigah LO. Prevalence of diabetes and pre-diabetes in Oke- Ogun region in Oyo State, Nigeria. J Medical Research and Health Education. 2017; 4 (1): 25.
[33] Muthunarayanan L, Ramraj B, Russel JK. Prevalence of pre-diabetes and its associated risk factors among rural adults in Tamil Nadu. Arch Med Health Sc. 2015; 3: 178-84.
[34] Chiwanga FS, Njelekela MA, Diamond MB et al. Urban and rural prevalence of diabetes and prediabetes and risk factors associated with diabetes in Tanzania and Uganda. Global Health Action. doi: 10.3402/ gha. V 9.31440. 2016; 9: 10.
[35] Hensel RL, Kempker RR, Tapia J, Oladele A, Blumberg HM and Magee MJ. Increased risk of latent tuberculosis infection among persons with prediabetes and diabetes mellitus. Int J Tuberc Lung Dis. doi: 10.5588/ijtld.15.0457. 2016; 20 (1): 71-78.
[36] Legesse M, Ameni G, Mamo G et al. Performance of Quantiferon-TB Gold In Tube for the diagnosis of Mycobacterium tuberculosis (Mtb) infection in Afar Pastoralists, Ethiopia. BMC Infectious Diseases. 2010; 10: 354.
[37] Sekandi JN, List J, Luzze H et al. Yield of undetected tuberculosis and human immunodeficiency virus co-infection from active case finding in urban Uganda. Int J Tuberc Lung Dis. 2014: 18 (1): 13-19.
[38] Shanaube K, Hargreaves J, Fielding K et al. Risk factors associated with positive QuantiFERON –TB Gold In-Tube and Tuberculin skin tests results in Zambia and South Africa, PLoS One. e18206. e. 2011; 6 (4).
[39] Colditz GA, Brewer TF, Berkey CS et al. Efficacy of BCG vaccine in the prevention of Tuberculosis: Meta-analysis of the Published Literature. JAMA. 1994; 271: 698-702.
[40] Ventura MT, Casciaro M, Gangemi S and Buquicchio R. Immunosenescence in aging: between immune cells depletion and cytokines up-regulation. Clin Mol Allergy. 2017; 15: 21.
Cite This Article
  • APA Style

    Benson Olu Akinshipe, Edirin Omorigho Yusuf, Felix Oladapo Akinshipe, Muyiwa Adeleye Moronkeji, Anthony Chukwuka Nwaobi. (2019). Prevalence and Determinants of Pre-diabetes and Latent Tuberculosis Infection Among Apparently Healthy Adults in Three Communities in Southern Nigeria. International Journal of Immunology, 7(2), 23-32. https://doi.org/10.11648/j.iji.20190702.11

    Copy | Download

    ACS Style

    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. Int. J. Immunol. 2019, 7(2), 23-32. doi: 10.11648/j.iji.20190702.11

    Copy | Download

    AMA Style

    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. Int J Immunol. 2019;7(2):23-32. doi: 10.11648/j.iji.20190702.11

    Copy | Download

  • @article{10.11648/j.iji.20190702.11,
      author = {Benson Olu Akinshipe and Edirin Omorigho Yusuf and Felix Oladapo Akinshipe and Muyiwa Adeleye Moronkeji and Anthony Chukwuka Nwaobi},
      title = {Prevalence and Determinants of Pre-diabetes and Latent Tuberculosis Infection Among Apparently Healthy Adults in Three Communities in Southern Nigeria},
      journal = {International Journal of Immunology},
      volume = {7},
      number = {2},
      pages = {23-32},
      doi = {10.11648/j.iji.20190702.11},
      url = {https://doi.org/10.11648/j.iji.20190702.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.iji.20190702.11},
      abstract = {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.},
     year = {2019}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Prevalence and Determinants of Pre-diabetes and Latent Tuberculosis Infection Among Apparently Healthy Adults in Three Communities in Southern Nigeria
    AU  - Benson Olu Akinshipe
    AU  - Edirin Omorigho Yusuf
    AU  - Felix Oladapo Akinshipe
    AU  - Muyiwa Adeleye Moronkeji
    AU  - Anthony Chukwuka Nwaobi
    Y1  - 2019/08/14
    PY  - 2019
    N1  - https://doi.org/10.11648/j.iji.20190702.11
    DO  - 10.11648/j.iji.20190702.11
    T2  - International Journal of Immunology
    JF  - International Journal of Immunology
    JO  - International Journal of Immunology
    SP  - 23
    EP  - 32
    PB  - Science Publishing Group
    SN  - 2329-1753
    UR  - https://doi.org/10.11648/j.iji.20190702.11
    AB  - 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.
    VL  - 7
    IS  - 2
    ER  - 

    Copy | Download

Author Information
  • Departments of Medical Microbiology, School of Clinical Medicine, Igbinedion University & Igbinedion University Teaching Hospital, Okada, Nigeria

  • Department of Medical Microbiology, School of Clinical Medicine, University of Benin/Teaching Hospital, Benin City, Nigeria

  • Department of Internal Medicine, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria

  • Department of Chemical Pathology, Ladoke Akintola University of Technology Teaching Hospital, Oshogbo, Nigeria

  • Department of Medical Laboratory Science, Igbinedion University, Okada, Nigeria

  • Sections