Prevalence of Tuberculosis among the Persons with Diabetes in Puducherry: A Community-Based Cross-Sectional Study

Abstract

Background: Persons with diabetes are at an increased risk of developing active tuberculosis, necessitating routine bidirectional screening under the National Tuberculosis Elimination Programme (NTEP) and the National Programme for Prevention and Control of Non-Communicable Diseases (NP-NCD; formerly the National Programme for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke, or NPCDCS). This study aimed to estimate the prevalence of tuberculosis and identify associated factors among persons with diabetes in selected field practice areas of Puducherry. Methods: A community-based cross-sectional study was conducted among 782 persons with diabetes registered under the NCD clinics of two Government Primary Health Centres in Puducherry from February 2021 to December 2022. Participants were screened for symptoms suggestive of TB using a validated structured questionnaire based on NTEP guidelines. Symptomatic individuals underwent sputum examination, CBNAAT, and chest radiography. Results: The prevalence of tuberculosis among persons with diabetes was 1.8% (95% CI: 0.97%–3%). In multivariable logistic regression analysis, male gender (aOR: 6.64; 95% CI: 1.28–34.35), family history of diabetes (aOR: 9.82; 95% CI: 1.99–48.28), significant weight loss (aOR: 84.68; 95% CI: 14.98–478.59), joint pain and swelling (aOR: 6.91; 95% CI: 1.20–39.77), and lack of physical activity (aOR: 4.47; 95% CI: 1.23–16.22) were independently associated with tuberculosis. Conclusion: The study identified a considerable burden of tuberculosis among persons with diabetes in the community. Active TB screening among diabetic individuals can facilitate early case detection and strengthen TB-DM collaborative activities under NTEP.