Prevalence and factors associated with tuberculosis infection among diabetic patients in the northeast state of Peninsular Malaysia

Kamariah Othman¹, Nur Nabila Abd Rahim^2*, Imanul Hassan Abdul Shukor^2,3, Mohd Shafik Abd Majid¹, Ahmad Zakwan Zainal¹, Hasliza Husin¹, Nor Harnani Ibrahim¹, Amira Fauzi¹, Mohd Anuar Abd Rahman⁴, Kasemani Embong⁴, Nurul Farehah Shahrir^1,2

1. Kemaman District Health Office, Ministry of Health Malaysia, Kemaman, Terengganu, Malaysia

2. Institute for Medical Research, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Malaysia

3. Institute for Health Management, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam, Malaysia

4. Terengganu State Health Department, Ministry of Health Malaysia, Kuala Terengganu, Terengganu, Malaysia

*Corresponding author: Nur Nabila Abd Rahim. This email address is being protected from spambots. You need JavaScript enabled to view it.

CITATION : Othman, K., Abd Rahim, N. N., Abdul Shukor, I. H., Abd Majid, M. S., Zainal, A. Z., Husin, H., Ibrahim, N. H., Fauzi, A., Abd Rahman, M. A., Embong, K., & Shahrir, N. F. (2026). Prevalence and factors associated with tuberculosis infection among diabetic patients in the northeast state of Peninsular Malaysia. International Medical Research Journal, 12(1), 42–53.  https://doi.org/10.63719/imrj.2026.12.01.004

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ABSTRACT

The link between tuberculosis and diabetes mellitus is a significant public health concern. This study aimed to determine the prevalence of tuberculosis and its associated risk factors among diabetic patients in Kemaman, Malaysia. In this cross-sectional study, we analysed secondary data from 225 diabetic patients randomly sampled from the National Diabetes Mellitus Registry (2015-2019) in Kemaman. Tuberculosis status was verified using the national surveillance registry, and data were analysed with logistic regression. The prevalence of tuberculosis was 17.0%. A longer duration of diabetes mellitus significantly increased tuberculosis risk (adjusted odds ratio 1.28; 95% CI: 1.14–1.44), while older age at diagnosis (adjusted odds ratio 0.86; 95% CI: 0.82–0.91) and being overweight or obese (adjusted odds ratio 0.20; 95% CI: 0.07–0.63) were significantly protective. Our findings reveal a complex interplay between metabolic health and immunity to tuberculosis. The paradoxical protective effect of a higher body mass index and older age at diagnosis, contrasted with the risk from prolonged diabetes mellitus, highlights the need for nuanced risk assessment to refine screening protocols. The 17.0% prevalence and the identification of age, body mass index, and duration of diabetes mellitus as crucial associated factors underscore the need for targeted public health strategies. Screening those diagnosed at a younger age.

KEYWORDS: Tuberculosis, DM mellitus, overweight and obese, age, duration