Approximately 5–15% of individuals infected with MTB progress to active TB disease within the first 2–5 years. This systematic review included six studies with 721 participants, ranging from 31 in Ethiopia to 240 in Nigeria. Half of the studies (n = 3, 50%) were conducted in Eastern Africa (Ethiopia and Kenya), two (33.3%) in Western Africa (Nigeria), and one (16.7%) in Northern Africa (Egypt).
Most studies recruited small sample sizes and provided limited data on participants' phenotypic characteristics. Two studies were conference proceedings with no full-text access, limiting details on participants' sociodemographic, anthropometric, and metabolic profiles. All studies were conducted in tertiary healthcare facilities, which may introduce bias in estimating the prevalence of TBI among individuals with DM.
Significant heterogeneity was observed among the studies, warranting cautious interpretation of the pooled effect size. The presence of TBI was primarily defined using IGRA tests (QuantiFERON® Gold In-Tube or T-SPOT.TB) in all six studies (100%). Only two studies also used TST in addition to IGRA. The pooled prevalence estimates of TBI were:
- 48% (95% CI 25–71%, I² = 98.15%, p < 0.001) using IGRA,
- 17% (95% CI 10–33%, I² = 94.00%, p < 0.001) using TST alone.
The overall pooled prevalence of TBI in the study population was 40% (95% CI 20–60%, I² = 98.52%, p < 0.001). A high burden of TBI was reported across four adult African populations with DM. Notably, participants aged ≥40 years and those with suboptimal glycemic control (HbA1c > 7%) had increased odds of TBI in three studies.
Source:
Kibirige, D., Andia-Biraro, I., Kyazze, A.P., Olum, R., Bongomin, F., Nakavuma, R.M., Ssekamatte, P., Emoru, R., Nalubega, G., Chamba, N. and Kilonzo, K., 2023. Burden and associated phenotypic characteristics of tuberculosis infection in adult Africans with diabetes: a systematic review. Scientific Reports, 13(1), p.19894.
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