Systematic review and meta-analysis: Prevalence of diabetes among patients with tuberculosis in China

Abstract

Objective: Tuberculosis (TB) and diabetes mellitus (DM) are both significant public health problems in China. Results of previous studies on the prevalence of DM among TB patients in China are inconsistent. We conducted this systematic review and meta-analysis to estimate the overall prevalence of DM among TB patients in China.

Methods: We systematically searched Excerpta Medica Database, PubMed, Global Health, Ovid MEDLINE(R), Chinese Biomedical Literature Service System, and China Online Journals -Health & Medicine and included all observational studies reporting prevalence of DM among TB patients in China. The Cochran's Q-statistic and $I^2$ were used to test heterogeneity. Finally, a random-effect model meta-analysis was conducted to estimate the pooled prevalence of DM among TB patients in China using R studio.

Results: We screened 7043 articles and identified 43 eligible studies. The pooled prevalence was 7.8% (95% prediction interval 1.6-30.5, $I^2$ = 99.2%). The highest prevalence was observed in Northeast China (21.9%) among four economic regions of China, followed by East Coast (8.3%), Western China (5.9%), with Central China having the lowest prevalence (5.1%). Higher prevalence was observed in urban (10.1%) than in rural (7.8%) areas, and in hospital-based (9.0%) than in population-based studies (6.9%).

Conclusions: This study suggests that the prevalence of DM among TB patients in China aligns with the overall DM prevalence among the public in China. Public health strategies to reduce the burden of TB-DM comorbidity and inequity are needed.

Keywords: China; comorbidities; diabetes mellitus; tuberculosis.