School of Medicine Publications

Document Type

Article

Publication Date

4-8-2026

Abstract

Background: Tuberculosis (TB)-diabetes is a growing public health threat in TB-endemic settings. We aimed to determine diabetes prevalence among TB patients in Greater Accra and its association with TB clinical presentation and treatment outcomes.

Methods: We enrolled 204 adults (≥20 years) with bacteriologically confirmed pulmonary TB across 14 health facilities. At treatment initiation, participants were screened for diabetes using self-report, fasting plasma glucose, and glycated hemoglobin, following standard diagnostic criteria. Baseline characteristics were recorded, and participants were followed to determine TB treatment outcomes. Associations between diabetes, baseline characteristics and treatment outcomes were assessed using bivariate and multivariate analysis in STATA. Adjusted odds ratios (AORs) and risk ratios (RRs) were estimated with 95% confidence intervals (CIs).

Results: The median age of participants was 40.5 years (IQR 30.5–50.5), and 72.5% were male. The prevalence of baseline diabetes was 22.1% (45/204), including 30 newly diagnosed and 15 previously diagnosed participants on treatment. Among 166 chest X-rays, cavities were less frequent in TB-diabetes than TB-only participants (51.2% vs. 72.5%, P = 0.014). Diabetes was associated with age ≥60 years (AOR 5.7, 95% CI 1.7–19.3), body mass index ≥25 kg/m2 (AOR 5.4, 95% CI 1.4–21.9), and family history of diabetes (AOR 3.7, 95% CI 1.5–9.4). Overall, 90.7% had favorable TB treatment outcomes, with unfavorable outcomes in 6.8% of TB-diabetes and 10.1% of TB-only participants (RR 0.68, 95% CI 0.2–2.2).

Conclusion: Diabetes was common among TB patients, with many previously undiagnosed. Despite similar treatment outcomes to TB-only participants, routine diabetes screening is recommended for early detection and management.

Comments

© 2026 Jones, Koram, Anto, Lauzardo, Restrepo, Lartey, Gbadamosi and Kwara.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication Title

Frontiers in Public Health

DOI

10.3389/fpubh.2026.1755479

Academic Level

faculty

Included in

Public Health Commons

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