Risk of tuberculosis in individuals with type 2 diabetes mellitus based on the tuberculosis predictive index score: a case-control study in Indonesia.

Abstract

Objectives: The co-occurrence of tuberculosis (TB) and diabetes mellitus presents a significant global health challenge, marked by a bidirectional relationship. This study aims to evaluate the effectiveness of the tuberculosis predictive index (TPI) score, developed by Isfandiari et al., in predicting TB occurrence among individuals living with type 2 diabetes mellitus.

Methods: A case-control study was conducted using primary data collected through questionnaires administered to individuals with type 2 diabetes mellitus, with and without pulmonary TB, at the internal medicine outpatient clinic of Fatmawati General Hospital from June to August 2024. The study compared TPI scores between those with type 2 diabetes mellitus who had TB and those who did not.

Results: TPI scores were significantly associated with TB risk. Individuals with both type 2 diabetes mellitus and TB had a 6.8-fold higher risk (95% confidence interval [CI], 2.6-17.6; p<0.001) than those without TB. Further chi-square analysis identified three significant risk factors: individuals with type 2 diabetes mellitus exhibiting TB-like symptoms had a 13.3-fold increased TB risk (95% CI, 5.1-34.3; p<0.001); those with a body mass index below 18.5 kg/m² had a 3.3-fold higher risk (95% CI, 1.0-11.0; p=0.039); and those living in poorly ventilated homes (ventilation ≤10%) had a 3.2-fold higher risk (95% CI, 1.0-9.8; p=0.035).

Conclusion: This study demonstrates that individuals with type 2 diabetes mellitus who developed TB had significantly higher TPI scores, corresponding to a 6.8-fold increased risk compared to their counterparts without TB. The TPI score may serve as a valuable tool for predicting TB risk among populations living with type 2 diabetes mellitus.