Co-occurrence of tuberculosis and diabetes mellitus, and associated risk factors, in Ethiopia: a systematic review and meta-analysis

Objective: The aim of our study was to estimate the pooled prevalence of tuberculosis (TB) and diabetes mellitus (DM) co-occurrences, and associated risk factors, in Ethiopia. Methods: In total, 392 articles were identified, and 14 were included in the analysis. The study's quality was assessed using the JBI tool. Data were analyzed using STATA version 16. The pooled prevalences of TB among DM patients and of DM among TB patients, with 95% CI, were estimated. In addition, the pooled OR values for each risk factor were estimated. The study's heterogeneity was assessed using forest plots and the I 2 heterogeneity test. Publication bias was assessed using funnel plots and Egger's regression test. Results: The pooled prevalence of TB among DM patients was 4.14% (95% CI 2.45-5.83%). The pooled prevalence of DM among TB patients was 12.77% (95% CI 6.91-18.62%). Type 1 DM patients had a higher TB risk (OR 2.70, 95% CI 1.41-3.99). Older age (OR 2.25, 95% CI 1.38-3.13) and family DM history (OR 3.65, 95% CI 1.89-5.41) were associated with DM co-occurrence among TB patients. Conclusions: Higher prevalences of TB among DM patients and of DM among TB patients were noted in Ethiopia, when compared with the general population. Thus, active screening of DM patients for TB and vice versa is recommended.