S Achanta1, R R Tekumalla2, J Jaju1, C Purad1, R Chepuri1, R Samyukta3, S Malhotra4, S B Nagaraja5, A M V Kumar6, A D Harries7. 1. World Health Organization Country Office in India, New Delhi, India. 2. District TB Centre, Ministry of Health and Family Welfare, Government of Andhra Pradesh, Visakhapatnam, India. 3. State TB Cell, Directorate General of Health Services, Ministry of Health and Family Welfare, Government of Andhra Pradesh, Hyderabad, India. 4. All India Institute of Medical Sciences, New Delhi, India. 5. World Health Organization Country Office in India, New Delhi, India ; Department of Community Medicine, Employees State Insurance Corporation (ESIC) Medical College, Bangalore, India. 6. International Union Against Tuberculosis and Lung Disease (The Union), South-East Asia Office, New Delhi, India. 7. The Union, Paris, France ; London School of Hygiene & Tropical Medicine, London, UK.
Abstract
SETTING: Ten peripheral health institutions of a tribal tuberculosis unit, Saluru, Vizianagaram District, South India. OBJECTIVE: To assess among tuberculosis (TB) patients: 1) the feasibility of screening for diabetes mellitus (DM), 2) the prevalence of DM, 3) the demographic and clinical features associated with DM, and 4) the number needed to screen (NNS) to find one new case of DM. DESIGN: Cross-sectional study: all TB patients registered from January to September 2012 were screened for DM using a screening questionnaire and random blood glucose, followed by fasting blood glucose (FBG) measurements using a glucometer. DM was diagnosed if FBG was ≥126 mg/dl. RESULTS: Of 381 patients, 374 (98%) were assessed for DM, suggesting feasibility of screening, and 19 (5%) were found to have DM (12 were newly diagnosed and 7 had a previous diagnosis of DM). The only characteristic associated with DM was age ≥40 years. The NNS to detect a new case of DM among all TB patients was 31; among those aged ≥40 years, the NNS was 20, and among current smokers it was 21. CONCLUSION: Screening of TB patients for DM was feasible and effective, and this should inform national scale-up. Other key considerations include the continued provision of free TB-DM screening, with co-location and integration of services.
SETTING: Ten peripheral health institutions of a tribal tuberculosis unit, Saluru, Vizianagaram District, South India. OBJECTIVE: To assess among tuberculosis (TB) patients: 1) the feasibility of screening for diabetes mellitus (DM), 2) the prevalence of DM, 3) the demographic and clinical features associated with DM, and 4) the number needed to screen (NNS) to find one new case of DM. DESIGN: Cross-sectional study: all TB patients registered from January to September 2012 were screened for DM using a screening questionnaire and random blood glucose, followed by fasting blood glucose (FBG) measurements using a glucometer. DM was diagnosed if FBG was ≥126 mg/dl. RESULTS: Of 381 patients, 374 (98%) were assessed for DM, suggesting feasibility of screening, and 19 (5%) were found to have DM (12 were newly diagnosed and 7 had a previous diagnosis of DM). The only characteristic associated with DM was age ≥40 years. The NNS to detect a new case of DM among all TB patients was 31; among those aged ≥40 years, the NNS was 20, and among current smokers it was 21. CONCLUSION: Screening of TB patients for DM was feasible and effective, and this should inform national scale-up. Other key considerations include the continued provision of free TB-DM screening, with co-location and integration of services.
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