Screening of patients with diabetes mellitus for tuberculosis in community health settings in China
This study assesses screening of patients with diabetes for TB in routine community health services
Abstract
Objective
To assess the feasibility and results of screening of patients with diabetes mellitus for TB in routine community health services in China.
Method
Agreement on how to screen patients with DM for TB and monitor and record the results was obtained at a stakeholders meeting. Subsequent training was carried out for staff at 10 community health centres, with activities implemented from June 2013 to April 2014. Patients with DM were screened for TB at each clinical visit using a symptom-based enquiry, and those positive to any symptom were referred to the TB clinic for TB investigation.
Results
A total of 2942 patients with DM visited these ten clinics. All patients received at least one screening for TB. Two patients were identified as already known to have TB. In total, 278 (9.5% of those screened) who had positive TB symptoms were referred for TB investigations and 209 arrived at the TB centre or underwent a chest radiograph for TB investigation. One patient (0.5% of those investigated) was newly diagnosed with active TB and was started on anti-TB treatment. The TB case notification rate of those screened was 102/100,000.
Conclusion
This pilot project shows it is feasible to carry out TB screening among patients with DM in community settings, but further work is needed to better characterise patients with DM at higher risk of TB. This may require a more targeted approach focused on high-risk groups such as those with untreated DM or poorly controlled hyperglycaemia.
This research was supported by the UK Department for International Development’s Operational Research Capacity Building Programme led by the International Union Against TB and Lung Disease (The Union)
Citation
Yan Lin, Anh Innes, Lin Xu, Ling Li, Jinou Chen, Jinglong Hou, Fengling Mi, Wanli Kang, Anthony D. Harries (2015) Screening of patients with diabetes mellitus for tuberculosis in community health settings in China Tropical Medicine and International Health volume 20 no 8 pp 1073–1080 doi:10.1111/tmi.12519
Links
Screening of patients with diabetes mellitus for tuberculosis in community health settings in China