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Diabetes mellitus and tuberculosis: programmatic management issues.

Harries AD, Kumar AM, Satyanarayana S, Lin Y, Zachariah R, Lönnroth K, Kapur A - Int. J. Tuberc. Lung Dis. (2015)

Bottom Line: In August 2011, the World Health Organization and the International Union Against Tuberculosis and Lung Disease launched the Collaborative Framework for Care and Control of Tuberculosis (TB) and diabetes mellitus (DM) to guide policy makers and implementers in combatting the epidemics of both diseases.Progress has been made, and includes identifying how best to undertake bidirectional screening for both diseases, how to provide optimal treatment and care for patients with dual disease and the most suitable framework for monitoring and evaluation.The link between DM and TB and the implementation of the collaborative framework for care and control have the potential to stimulate and strengthen the scale-up of non-communicable disease care and prevention programmes, which may help in reducing not only the global burden of DM but also the global burden of TB.

View Article: PubMed Central - PubMed

Affiliation: International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; London School of Hygiene & Tropical Medicine, London, UK.

ABSTRACT
In August 2011, the World Health Organization and the International Union Against Tuberculosis and Lung Disease launched the Collaborative Framework for Care and Control of Tuberculosis (TB) and diabetes mellitus (DM) to guide policy makers and implementers in combatting the epidemics of both diseases. Progress has been made, and includes identifying how best to undertake bidirectional screening for both diseases, how to provide optimal treatment and care for patients with dual disease and the most suitable framework for monitoring and evaluation. Key programmatic challenges include the following: whether screening should be directed at all patients or targeted at those with high-risk characteristics; the most suitable technologies for diagnosing TB and diabetes in routine settings; the best time to screen TB patients for DM; how to provide an integrated, coordinated approach to case management; and finally, how to persuade non-communicable disease programmes to adopt a cohort analysis approach, preferably using electronic medical records, for monitoring and evaluation. The link between DM and TB and the implementation of the collaborative framework for care and control have the potential to stimulate and strengthen the scale-up of non-communicable disease care and prevention programmes, which may help in reducing not only the global burden of DM but also the global burden of TB.

No MeSH data available.


Related in: MedlinePlus

Page of a Tuberculosis-Diabetes Register showing how TB patients were screened for DM and the results recorded at TB Units, in India (adapted from 12). TB = tuberculosis; DM = diabetes mellitus; Y = yes; N = no; RBG = random blood glucose; FBG = fasting blood glucose.
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i1027-3719-19-8-879-f01: Page of a Tuberculosis-Diabetes Register showing how TB patients were screened for DM and the results recorded at TB Units, in India (adapted from 12). TB = tuberculosis; DM = diabetes mellitus; Y = yes; N = no; RBG = random blood glucose; FBG = fasting blood glucose.

Mentions: The cornerstone of good TB control programmes is a standardised monitoring and evaluation system providing quarterly reports on the number of patients registered for anti-tuberculosis treatment, the types and categories of TB and their treatment outcomes. It has thus been relatively easy to build into this system a monitoring and evaluation framework for DM screening, similar to what is currently being done for HIV/AIDS (acquired immune-deficiency syndrome) and antiretroviral therapy.39 In the large studies in India and China,12,17 TB patients were screened for DM according to a set algorithm, and results were recorded in a separate TB-DM register linked to the main TB patient register through TB registration numbers (Figure 1). The same format was used to prepare quarterly reports on aggregate data, provide an understanding of what steps worked and the results of each screening component. However, the quantity of data provided in such a monitoring and evaluation system is too much for a national TB programme that simply wants to know how many TB patients were screened, how many were diagnosed with DM, how many were referred for DM care and what the treatment outcomes were. Figure 2 (A and B) shows how this information was integrated into the TB treatment cards and TB patient registers in India after the country had made a policy decision in 2012 to screen all TB patients for DM.


Diabetes mellitus and tuberculosis: programmatic management issues.

Harries AD, Kumar AM, Satyanarayana S, Lin Y, Zachariah R, Lönnroth K, Kapur A - Int. J. Tuberc. Lung Dis. (2015)

Page of a Tuberculosis-Diabetes Register showing how TB patients were screened for DM and the results recorded at TB Units, in India (adapted from 12). TB = tuberculosis; DM = diabetes mellitus; Y = yes; N = no; RBG = random blood glucose; FBG = fasting blood glucose.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4497633&req=5

i1027-3719-19-8-879-f01: Page of a Tuberculosis-Diabetes Register showing how TB patients were screened for DM and the results recorded at TB Units, in India (adapted from 12). TB = tuberculosis; DM = diabetes mellitus; Y = yes; N = no; RBG = random blood glucose; FBG = fasting blood glucose.
Mentions: The cornerstone of good TB control programmes is a standardised monitoring and evaluation system providing quarterly reports on the number of patients registered for anti-tuberculosis treatment, the types and categories of TB and their treatment outcomes. It has thus been relatively easy to build into this system a monitoring and evaluation framework for DM screening, similar to what is currently being done for HIV/AIDS (acquired immune-deficiency syndrome) and antiretroviral therapy.39 In the large studies in India and China,12,17 TB patients were screened for DM according to a set algorithm, and results were recorded in a separate TB-DM register linked to the main TB patient register through TB registration numbers (Figure 1). The same format was used to prepare quarterly reports on aggregate data, provide an understanding of what steps worked and the results of each screening component. However, the quantity of data provided in such a monitoring and evaluation system is too much for a national TB programme that simply wants to know how many TB patients were screened, how many were diagnosed with DM, how many were referred for DM care and what the treatment outcomes were. Figure 2 (A and B) shows how this information was integrated into the TB treatment cards and TB patient registers in India after the country had made a policy decision in 2012 to screen all TB patients for DM.

Bottom Line: In August 2011, the World Health Organization and the International Union Against Tuberculosis and Lung Disease launched the Collaborative Framework for Care and Control of Tuberculosis (TB) and diabetes mellitus (DM) to guide policy makers and implementers in combatting the epidemics of both diseases.Progress has been made, and includes identifying how best to undertake bidirectional screening for both diseases, how to provide optimal treatment and care for patients with dual disease and the most suitable framework for monitoring and evaluation.The link between DM and TB and the implementation of the collaborative framework for care and control have the potential to stimulate and strengthen the scale-up of non-communicable disease care and prevention programmes, which may help in reducing not only the global burden of DM but also the global burden of TB.

View Article: PubMed Central - PubMed

Affiliation: International Union Against Tuberculosis and Lung Disease (The Union), Paris, France; London School of Hygiene & Tropical Medicine, London, UK.

ABSTRACT
In August 2011, the World Health Organization and the International Union Against Tuberculosis and Lung Disease launched the Collaborative Framework for Care and Control of Tuberculosis (TB) and diabetes mellitus (DM) to guide policy makers and implementers in combatting the epidemics of both diseases. Progress has been made, and includes identifying how best to undertake bidirectional screening for both diseases, how to provide optimal treatment and care for patients with dual disease and the most suitable framework for monitoring and evaluation. Key programmatic challenges include the following: whether screening should be directed at all patients or targeted at those with high-risk characteristics; the most suitable technologies for diagnosing TB and diabetes in routine settings; the best time to screen TB patients for DM; how to provide an integrated, coordinated approach to case management; and finally, how to persuade non-communicable disease programmes to adopt a cohort analysis approach, preferably using electronic medical records, for monitoring and evaluation. The link between DM and TB and the implementation of the collaborative framework for care and control have the potential to stimulate and strengthen the scale-up of non-communicable disease care and prevention programmes, which may help in reducing not only the global burden of DM but also the global burden of TB.

No MeSH data available.


Related in: MedlinePlus