Latent tuberculosis infection and diagnostic performance of the tuberculin skin test among type 2 diabetics in Sana’a city, Yemen

Abstract

Background: Tuberculosis (TB) is one of the most widespread infectious diseases worldwide, typically persisting in the body as latent TB infection (LTBI). Patients with type 2 diabetes have an increased risk of LTBI progressing to active TB. This study determined the prevalence and predictors of LTBI and assessed the agreement between tuberculin skin test (TST) and interferon-gamma release assay (IGRA) in diagnosing LTBI among type 2 diabetics in Sana’a city, Yemen. Methods: A cross-sectional study was conducted among 150 type 2 diabetics in private health facilities in Sana’a in 2023. Demographic, diabetes-related, and potential LTBI risk factor data were collected, and patients were screened using TST and IGRA. Univariate analysis and multivariable binary logistic regression were used to identify predictors, and agreement between TST and IGRA was assessed using Cohen’s kappa. Results: LTBI was prevalent among 29.3% of type 2 diabetics using both tests, 25.3% with IGRA and 21.3% with TST. Male gender was an independent predictor of LTBI, while being employed and longer duration since diabetes diagnosis were predictors of lower LTBI risk. Agreement between TST and IGRA was 88%, with good and statistically significant agreement. Conclusions: LTBI is common among type 2 diabetics seeking medical care in Sana’a city. TST shows good agreement with IGRA in diagnosing LTBI among type 2 diabetics, supporting its continued use as a cost-effective and accessible test in the country.