INTRODUCTION: World Health Organization recommendations of bidirectional screening for tuberculosis (TB) and diabetes have been met with varying levels of uptake by national TB programs in resource-limited settings. METHODOLOGY: Kibong'oto Infectious Diseases Hospital (KIDH) is a referral hospital for TB from northern Tanzania, and the national referral hospital for multidrug-resistant (MDR)-TB. Glycated hemoglobin (HgbA1c) testing was done on patients admitted to KIDH for newly diagnosed TB, retreatment TB, and MDR-TB, to determine the point prevalence of diabetes (HgbA1c ≥ 6.5%) and prediabetes (HgbA1c 5.7%-6.4%). RESULTS: Of 148 patients hospitalized at KIDH over a single week, 59 (38%) had no prior TB treatment, 22 (15%) were retreatment cases, and 69 (47%) had MDR-TB. Only 3 (2%) had a known history of diabetes. A total of 144 (97%) had successful screening, of which 110 (77%) had an HgbA1c ≤ 5.6%, 28 (19%) had ≥ 5.7 < 6.5, and 6 (4%) had ≥ 6.5. Comparing subjects with prediabetes or diabetes to those with normal A1c levels, retreatment patients were significantly more likely to have a A1c ≥ 5.7% (odds ratio: 3.2, 95% CI: 1.2-9.0; p = 0.02) compared to those without prior TB treatment. No retreatment case was a known diabetic, thus the number needed to screen to diagnose one new case of diabetes among retreatment cases was 11. CONCLUSIONS: Diabetes prevalence by HgbA1c was less common than expected, but higher HgA1c values were significantly more frequent among retreatment cases, allowing for a rational, resource-conscious screening approach.
INTRODUCTION: World Health Organization recommendations of bidirectional screening for tuberculosis (TB) and diabetes have been met with varying levels of uptake by national TB programs in resource-limited settings. METHODOLOGY:Kibong'oto Infectious Diseases Hospital (KIDH) is a referral hospital for TB from northern Tanzania, and the national referral hospital for multidrug-resistant (MDR)-TB. Glycated hemoglobin (HgbA1c) testing was done on patients admitted to KIDH for newly diagnosed TB, retreatment TB, and MDR-TB, to determine the point prevalence of diabetes (HgbA1c ≥ 6.5%) and prediabetes (HgbA1c 5.7%-6.4%). RESULTS: Of 148 patients hospitalized at KIDH over a single week, 59 (38%) had no prior TB treatment, 22 (15%) were retreatment cases, and 69 (47%) had MDR-TB. Only 3 (2%) had a known history of diabetes. A total of 144 (97%) had successful screening, of which 110 (77%) had an HgbA1c ≤ 5.6%, 28 (19%) had ≥ 5.7 < 6.5, and 6 (4%) had ≥ 6.5. Comparing subjects with prediabetes or diabetes to those with normal A1c levels, retreatment patients were significantly more likely to have a A1c ≥ 5.7% (odds ratio: 3.2, 95% CI: 1.2-9.0; p = 0.02) compared to those without prior TB treatment. No retreatment case was a known diabetic, thus the number needed to screen to diagnose one new case of diabetes among retreatment cases was 11. CONCLUSIONS:Diabetes prevalence by HgbA1c was less common than expected, but higher HgA1c values were significantly more frequent among retreatment cases, allowing for a rational, resource-conscious screening approach.
Authors: Christie Y Jeon; Anthony D Harries; Meghan A Baker; Jessica E Hart; Anil Kapur; Knut Lönnroth; Salah-Eddine Ottmani; Sunali Goonesekera; Megan B Murray Journal: Trop Med Int Health Date: 2010-09-24 Impact factor: 2.622
Authors: Bachti Alisjahbana; Edhyana Sahiratmadja; Erni J Nelwan; Anugrah Maya Purwa; Yana Ahmad; Tom H M Ottenhoff; Ronald H H Nelwan; Ida Parwati; Jos W M van der Meer; Reinout van Crevel Journal: Clin Infect Dis Date: 2007-07-05 Impact factor: 9.079
Authors: Meghan A Baker; Anthony D Harries; Christie Y Jeon; Jessica E Hart; Anil Kapur; Knut Lönnroth; Salah-Eddine Ottmani; Sunali D Goonesekera; Megan B Murray Journal: BMC Med Date: 2011-07-01 Impact factor: 8.775
Authors: Daniel Faurholt-Jepsen; Nyagosya Range; George Praygod; Kidola Jeremiah; Maria Faurholt-Jepsen; Martine Grosos Aabye; John Changalucha; Dirk Lund Christensen; Christian Bressen Pipper; Henrik Krarup; Daniel Rinse Witte; Aase Bengaard Andersen; Henrik Friis Journal: PLoS One Date: 2011-08-30 Impact factor: 3.240
Authors: Stellah G Mpagama; Kaushik Ramaiya; Troels Lillebæk; Blandina T Mmbaga; Marion Sumari-de Boer; Nyanda Elias Ntinginya; Jan-Willem Alffenaar; Scott K Heysell; Ib C Bygbjerg; Dirk L Christensen Journal: BMJ Open Date: 2021-04-28 Impact factor: 2.692
Authors: Patrick L Mabula; Kelly I Kazinyingia; Edwin Christian Chavala; Victor Mosha; Sia E Msuya; Beatrice John Leyaro Journal: East Afr Health Res J Date: 2021-06-11