title: Tuberculosis and diabetes mellitus in the Republic of Kiribati: a case-control study.
abstract: OBJECTIVE
  To better inform local management of TB-diabetes collaborative activities, we aimed to determine the prevalence of diabetes among persons with and without TB and to determine the association between TB and diabetes in Kiribati, a Pacific Island nation.
  
  
  METHODS
  We compared consecutively enrolled TB cases to a group of randomly selected community controls without evidence of TB. Diabetes was diagnosed by HbA1c, and clinical and demographic data were collected. A tuberculin skin test was administered to controls. The chi-square test was used to assess significance in differences between cases and controls. We also calculated an odds ratio, with 95% confidence intervals, for the odds of diabetes among cases relative to controls. Unweighted multivariate logistic regression was performed to adjust for the effects of age and sex.
  
  
  RESULTS
  A total of 275 TB cases and 499 controls were enrolled. The diabetes prevalence in cases (101, 37%) was significantly greater than in controls (94, 19%) (adjusted odds ratio: 2.8; 95% CI 2.0-4.1). Fifty-five percent (108) of all diabetic diagnoses were new; this proportion was higher among controls (64.8%) than cases (46.5%). Five patients with TB were screened to detect one patient with diabetes.
  
  
  CONCLUSIONS
  There is a strong association between TB and diabetes in Kiribati and bidirectional screening should be conducted in this setting.
authors.affiliation: Public Health Division, Secretariat of the Pacific Community, Noumea, New Caledonia.|National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
authors.forename: K
authors.initials: K
authors.lastname: Viney
authors.affiliation: Division of TB Elimination, United States Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Cavanaugh
authors.affiliation: National TB Programme, Ministry of Health and Medical Services, Tarawa, Kiribati.
authors.forename: T
authors.initials: T
authors.lastname: Kienene
authors.affiliation: National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
authors.forename: D
authors.initials: D
authors.lastname: Harley
authors.affiliation: Population Health Division, ACT Health Directorate, Canberra, ACT, Australia.|Australian National University Medical School, Canberra, ACT, Australia.
authors.forename: P M
authors.initials: PM
authors.lastname: Kelly
authors.affiliation: National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Sleigh
authors.affiliation: Public Health Consultant, Auckland, New Zealand.
authors.forename: J
authors.initials: J
authors.lastname: O'Connor
authors.affiliation: Division of TB Elimination, United States Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Mase
keywords: Pacific; Pacifique; Pacífico; Tuberculosis; case-control study; diabetes mellitus; diabète sucré; estudio caso-control; tuberculose; étude cas-témoins