Diabetes mellitus, TB, and HIV multi-morbidities among adults in Uganda

Antiretroviral therapy has extended HIV patient survival, increasing non-communicable disease prevalence like diabetes mellitus. Strong links exist between HIV, TB, and diabetes. This study examined diabetes prevalence among adults with TB and HIV, or co-infection in Uganda.

Cross-sectional study conducted between August 2021 and January 2022 at three urban hospitals in Kampala, Uganda. Participants aged ≥18 years receiving HIV and/or TB treatment for at least 6 months were enrolled. Diabetes screening was performed using random blood glucose and haemoglobin A1C measurements according to American Diabetes Association guidelines.

Among 924 participants, 832 (90.0%) had HIV only, 50 (5.4%) had TB only, and 42 (4.6%) had both conditions. Overall diabetes prevalence was 4.1% in HIV patients, 7.6% in TB patients, and 14.3% in TB-HIV co-infected patients. Diabetes was significantly more prevalent among older patients (≥36 years) across all disease categories and among males with HIV infection compared to females (6.8% vs. 3.0%, P = 0.011). Among TB patients, central obesity was associated with higher diabetes prevalence (33.3% vs. 4.2%, P = 0.007).

The study reveals elevated diabetes prevalence among patients with TB-HIV co-infection, emphasising the need for integrated screening and management strategies addressing these interconnected conditions in Uganda.