PREVALENCE OF TUBERCULOSIS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS ADMITTED TO MEDICAL UNIT-II, PMCH NAWABSHAH, PAKISTAN

Abstract

Background and Objectives: Type 2 Diabetes Mellitus (T2DM) and Tuberculosis (TB) represent a growing dual disease burden in low- and middle-income countries. This study aimed to investigate the frequency, clinical spectrum, and associated risk determinants of active TB among hospitalized T2DM patients admitted to Medical Unit-II, Peoples Medical College Hospital (PMCH), Nawabshah, Sindh, Pakistan.

Methodology: A descriptive cross-sectional study was conducted enrolling 375 consecutive patients with established T2DM (≥6 months’ duration, HbA1c > 6.5%) presenting with respiratory or systemic symptoms suggestive of TB. Diagnostic evaluation included Ziehl–Neelsen (ZN) sputum smear microscopy, GeneXpert MTB/RIF molecular assay, and chest radiography. Socio-demographic, anthropometric, and clinical parameters were analyzed using SPSS v20.

Results: Comparative synthesis of hospital-based Pakistani data revealed an active TB prevalence ranging between 12.0% and 21.71% among diabetic cohorts. Co-infected patients demonstrated a marked male predominance (~60.0%–61.1%) and a strong concentration in individuals aged >40 years (peak between 51–60 years). Prolonged diabetes duration (≥10 years, mean 12.41 ± 2.15 years) was significantly correlated with active TB positivity (p < 0.001). Clinical disease subtypes comprised Pulmonary TB (47.4%–56.7%), Extra-Pulmonary TB (34.2%–43.3%), and Multidrug-Resistant TB (MDR-TB, 13.2%–20.0%). Sputum smear positivity reached 60.0%–71.2%, with chest radiography showing cavitary lesions in 48.57% of cases.

Conclusion: Active TB co-infection is highly prevalent among hospitalized T2DM patients in Nawabshah, driven by chronic hyperglycemia, prolonged diabetes duration, and low socioeconomic status. Institutional bidirectional screening is imperative to curb drug resistance and adverse clinical outcomes.