Diabetes and tuberculosis comorbidity: a cross-sectional study of patients attending diabetes clinic in Accra, Ghana

Background: Diabetes and tuberculosis have significantly increased health-related and socioeconomic implications on individuals, families, health systems, and the global economy at large, making them a serious global health concern. The objective of this study is to determine the prevalence of diabetes-tuberculosis co-morbidity and the socio-demographic, behavioral and clinical factors associated with this comorbidity. Methodology: This was a cross-sectional study of selected diabetic patients at the diabetic clinic of the Shai Osudoku District Hospital-Dodowa in the Greater Accra Region, Ghana. Sputum samples from confirmed diabetics were screened for tuberculosis using GeneXpert MTB/RIF Test and Ziehl-Neelsen AFB Microscopy. The patients’ awareness of their susceptibility to diabetes-tuberculosis, treatment compliance and care manager attentiveness, were assessed through semi-structured questionnaire. Statistical analyses of data were performed using Microsoft Analysis Tool Pak. Results: The prevalence of diabetes-tuberculosis comorbidity in the study was 7.0% (7/100). The occurrence of diabetes-tuberculosis comorbidity among the participants seemed to be higher in males (11.1%, 3/27) as compared to female (5.5%, 4/73), with no statistically significant difference (p=0.327). The females with diabetes-tuberculosis comorbidity statistically demonstrated poorer glycaemic control (females: 17.08±0.79 mmol/L and males: 15.95±0.79 mmol/L; 95% Cl; 7.15, p<0.001). Participants in the age group 61-80 years had the highest prevalence of 11.4% (4/35) for diabetics-tuberculosis comorbidity but this was not statistically significant (p=0.509), although their mean blood glucose was significantly higher than other age groups (p=0.0137). The mean of patients with no awareness of their susceptibility to diabetic-tuberculosis co-morbidity was 77±28.97% (95% CI=3.79-46.62, p=0.4648). Treatment compliance was observed in 91.0% of the study participants mainly due to high level of attentiveness by care providers at the diabetic clinic for 69.0% of the participants. Conclusions: The prevalence of diabetes-tuberculosis comorbidity in this study is 7.0%, with majority of the diabetics not aware of their susceptibility to tuberculosis although there was high treatment compliance. There is the need for the adoption of a collaborative framework and integrated approach in the clinical management and control of diabetes and tuberculosis.