The prevalence and determinants of active tuberculosis among diabetes patients attending a primary health care clinic in Cape Town, South Africa

Background: The number of studies addressing the association between diabetes mellitus (DM) and tuberculosis (TB) in the context of sub - Saharan Africa (SSA) is limited and fewer studies have determined whether DM is associated with TB among patients attending DM c linics. We aimed to assess the prevalence of TB among a population, diagnosed and receiving treatment for DM at a primary care clinic, and to identify significant risk factors of prevalent TB cases. Methods In this cross - sectional study, adult DM patients attending an outpatient clinic at a South African township were evaluated for TB using Xpert MTB/RIF testing (Xpert) and other conventional methods - clinical symptom screening, smear microscopy, chest x - ray, and culture. Socio - demographic and biochemical information were collected using the Who's STEPwise approach to surveillance of chronic disease risk factors. Findings 451 DM patients were screened for TB. 16 DM patients were diagnosed with TB, following screening giving a prevalence rate of 3 · 55% or 35 · 48 per 1000 people [95% CI: 2 · 18 - 5 · 72]. 37 · 50% (n=6) of TB cases reported at least one clinical symptom of TB [95% CI: 17 · 34 - 63 · 11%]. 62 · 5% (n=10; 95% CI :) of TB cases were HIV - positive. In a multivariate analysis, HIV (OR : 14 · 58 , p<0 · 001) and haemoptysis (OR 24 · 48, p