B Naik1, A M V Kumar2, S Satyanarayana2, M D Suryakant3, N M V Swamy4, S Nair1, P Isaakidis5, A D Harries6. 1. World Health Organization Country Office for India, New Delhi, India. 2. International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India. 3. State Tuberculosis Centre, Ministry of Health and Family Welfare, Government of Karnataka, Bangalore, India. 4. District Tuberculosis Centre, Ministry of Health and Family Welfare, Government of Karnataka, Kolar, India. 5. Médecins Sans Frontières, Mumbai, India. 6. The Union, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
Abstract
SETTING: Seventeen peripheral health institutions (PHI) in Kolar district (population: 0.5 million), South India. OBJECTIVE: To assess the feasibility and results of screening patients with tuberculosis (TB) for diabetes mellitus (DM) at peripheral level. DESIGN: From January to September 2012, all TB patients were assessed for DM. Those with unknown DM status were screened for the disease (free of charge) by trained laboratory technicians at each PHI, using a glucometer supplied by the national programme on a capillary blood sample. Those with fasting blood glucose (FBG) ≥ 126 mg/dl (≥7 mM) were diagnosed as DM-positive. RESULTS: Of 362 TB patients, 358 (99%) were assessed for DM and 62 (17.1%) had the diseases-53 (14.6%) had a previous history of DM and 9 (2.9%) were newly diagnosed. All new DM patients were enrolled into DM care. Higher DM prevalence was found among TB patients aged ≥40 years, smokers and those with smear-positive pulmonary TB. To detect a new case of DM, the number needed to screen (NNS) among TB patients was 40. CONCLUSION: Screening of TB patients for DM was feasible and effective in a peripheral setting. The availability of trained laboratory technicians and free services at every PHI made the intervention feasible. The study has contributed towards a national policy decision in this regard.
SETTING: Seventeen peripheral health institutions (PHI) in Kolar district (population: 0.5 million), South India. OBJECTIVE: To assess the feasibility and results of screening patients with tuberculosis (TB) for diabetes mellitus (DM) at peripheral level. DESIGN: From January to September 2012, all TB patients were assessed for DM. Those with unknown DM status were screened for the disease (free of charge) by trained laboratory technicians at each PHI, using a glucometer supplied by the national programme on a capillary blood sample. Those with fasting blood glucose (FBG) ≥ 126 mg/dl (≥7 mM) were diagnosed as DM-positive. RESULTS: Of 362 TB patients, 358 (99%) were assessed for DM and 62 (17.1%) had the diseases-53 (14.6%) had a previous history of DM and 9 (2.9%) were newly diagnosed. All new DMpatients were enrolled into DM care. Higher DM prevalence was found among TB patients aged ≥40 years, smokers and those with smear-positive pulmonary TB. To detect a new case of DM, the number needed to screen (NNS) among TB patients was 40. CONCLUSION: Screening of TB patients for DM was feasible and effective in a peripheral setting. The availability of trained laboratory technicians and free services at every PHI made the intervention feasible. The study has contributed towards a national policy decision in this regard.
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