Prevalence of Documented Diabetes Mellitus and Associated Factors among Adult Tuberculosis Patients Registered At Selected Tuberculosis Units of Jhansi District, Uttar Pradesh: A Retrospective Cohort Study

Abstract

Background: India has the highest tuberculosis (TB) burden and a growing burden of diabetes mellitus (DM), which worsens TB outcomes. Sub-district TB-DM data from Bundelkhand are scarce.

Aims and Objective: To estimate the prevalence of documented DM among adult TB patients at two tuberculosis units (TUs) of Jhansi district and to identify associated factors and treatment outcomes.

Materials and Methods: This record-based retrospective cohort study included 259 eligible adult TB patients notified on the Ni-kshay portal at Badagaon (n=121) and Chirgaon (n=138) TUs between March 2023 and May 2024. Data were analysed using chi-square/Fisher’s exact tests and Firth penalised logistic regression.

Results: Mean age was 40.8±15.1 years; 68.3% were males, 86.1% rural and 54.1% underweight. The prevalence of documented DM was 6.9% (18/259; 95% CI 4.4–10.7); all cases were previously known type 2 DM. On bivariate analysis, DM was associated with age (15.5% at 40–59 years; p<0.001), lower education and unskilled occupation; in the Firth model, only age ≥40 years remained associated (adjusted OR 10.38; 95% CI 2.29–99.69). Treatment success was 97.7%. Crude case fatality was higher with documented DM (22.2% vs 0.4%), but was based on only five deaths and not adjusted for confounding.

Conclusion: About one in fourteen adult TB patients had documented DM, concentrated among those aged ≥40 years; the true prevalence may be higher because undiagnosed DM may have been missed. Bidirectional screening with confirmatory glycaemic testing should be strengthened.