Pre-diabetes and Latent Tuberculosis Infection in Southern Nigeria

A multi-community cross-sectional study conducted from September to December 2018 involved 352 adult volunteers from three different geographic sites: villagers, semi-urbanites, and urbanites. Participants underwent risk screening using a modified WHO STEPS instrument. The demographic distribution included an equal number of males and females, with the majority being over 40 years old and married or cohabiting. A significant portion had no family history of diabetes or tuberculosis, and most were not hypertensive. However, obesity was notably more common among urban participants.

The study found that nearly all participants had received BCG vaccination, and there were no significant site-specific differences in CD4+ T lymphocyte counts, hemoglobin levels, or C-reactive protein profiles. However, total cholesterol levels differed significantly across the groups, with no such difference observed for LDL-C and HDL-C, although rural dwellers had slightly higher HDL-C levels.

Pre-diabetes (PDM) and latent tuberculosis infection (LTBI) were assessed with prevalence rates showing urban areas having higher rates of PDM compared to semi-urban and rural areas. LTBI was conversely more common in rural settings. A small subset of participants had both conditions (PDM-LTBI), with prevalence among those with LTBI being notably higher than in those without.

Bivariate analysis indicated that several factors like age, smoking, family history of diabetes, abdominal obesity, hypertension, and lack of BCG vaccination were associated with PDM, while similar factors plus educational level and family history of TB were linked with LTBI. Logistic regression confirmed age, smoking, family history of diabetes, and lack of BCG vaccination as significant predictors for both conditions, with older age and absence of BCG vaccination being particularly predictive of concurrent PDM and LTBI. Specifically, adults aged 50-59 years were at a much higher risk of having both conditions compared to younger adults, and BCG vaccination significantly reduced this risk.

References:

1. Akinshipe, B.O., Yusuf, E.O., Akinshipe, F.O., Moronkeji, M.A. and Nwaobi, A.C., 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), pp.23-32.