People with latent tuberculosis (TB) infection are not sick because their bodies are still able to fight the (TB) bacteria to stop them from growing. On the other hand, people with TB disease are those who are sick as their body cannot stop the bacteria from growing. That is why the US national public health Agency, CDC, says that TB is a serious health threat, especially for people living with diabetes. According to the International Diabetes Federation (IDF), around 13.1 million people are living with diabetes in Bangladesh and the number is projected to double by 2025. As diabetes compromises body's immune system, the above figure should be a cause for serious concern because there is a dearth of dependable statistics on how many among this pre-diabetic or diabetic population do also have latent TB infection or active TB disease.
In this context, according to a recent study done by the Diabetic Association of Bangladesh (BADAS), TB prevalence is much higher than thought among the diabetic patients in Bangladesh. Going by the World Health Organization (WHO)'s Tuberculosis Report 2022, the information about over 0.3 million people suffering from TB in the country was notified to the National Tuberculosis Control Programme (NTP) in 2021. The incidence of the disease was found to be 221 for every 100,000 people. Of these 100,000 infected people, 25 die of the disease, the report further says. Between 2020 and 2021, BADAS also carried out a similar survey in collaboration with an international aid agency, USAID, and health service provider and research body, ICDDR, B. That study identified 70,000 cases, having a condition called 'presumptive persons' as they had symptoms of TB. It further found that of over 6,700 people diagnosed with TB, 70 per cent had diabetes.
In a country where a large segment of the population cannot afford the required diet to maintain proper nutritional standard, it is hardly surprising that so many people have been identified with presumptive TB condition along with diabetes. Such a combination of diabetes and TB, doctors warn, can create what they term a 'perfect storm', for a lack of proper nutrition in a person provides the ideal ground for developing TB, especially among those who have TB germs in their body but are still not sick with the disease. It is worthwhile to note at this point that poor level of nutrition, among other problems, severely weakens a person's immunity against various infections including that from TB. If those nutritionally deficient people have the added condition of pre-diabetes or diabetes, their immune system is doubly compromised.
On this score, one wonders, if there is any statistics with the government on the number of such people in the country who have poor level of nutrition and at the same time are also diabetic. Whatever the condition was before the soaring food prices and runaway inflation that hit hard the low-income and poverty-stricken population of the country, any current survey in this regard may prove to be a shocker for those concerned. Even so, a study should be done to know how many of them are diabetic as well as have TB and hence are a candidate for what doctors term a 'perfect storm'. The situation calls for treating diabetes and TB among the population with equal importance and doing everything to stop the impending perfect storm from happening.