Factors Affecting the Risk of Pulmonary Tuberculosis Among Patients with Type 2 Diabetes Mellitus

Abstract

Tuberculosis is an infectious disease that ranks among the top ten causes of death worldwide. The high incidence and mortality rates of TB are associated with diabetes mellitus, an underlying condition that increases susceptibility to TB infection. This study aims to identify factors affecting the risk of tuberculosis in patients with type 2 diabetes mellitus. This unmatched case-control study was conducted at ten community health centers in Medan. The sample size consisted of 64 cases and 64 controls, selected using purposive sampling. Data collection was completed using questionnaires. The collected data were analyzed using logistic regression analysis. Study results suggested that factors significantly affecting the risk of tuberculosis in patients with diabetes mellitus were adherence to diabetes mellitus treatment (OR: 3.194 (1.511-6.751); p=0.002), smoking (OR: 7.857 (3.551-17.384); p < 0.001), overweight (BMI >25 kg/m²) (OR: 0.269 (0.118–0.613); p=0.002), and the use of masks (OR: 0.427 (0.208–0.878); p=0.021). Smoking is the strongest predictor of tuberculosis in patients with type 2 diabetes mellitus. Community health centers should integrate smoking cessation campaigns into tuberculosis prevention programs, provide nutritional interventions for malnourished diabetes patients, assess and improve adherence to diabetes treatment, and promote mask usage among diabetes patients who have direct contact with tuberculosis patients.