objectives 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.