Screening diabetes mellitus patients for pulmonary tuberculosis: a multisite study in Indonesia, Peru, Romania and South Africa.
Trans R Soc Trop Med Hyg
; 115(6): 634-643, 2021 06 02.
Article
em En
| MEDLINE
| ID: mdl-33118039
BACKGROUND: Diabetes mellitus (DM) patients are three times more likely to develop tuberculosis (TB) than the general population. Active TB screening in people with DM is part of a bidirectional approach. The aim of this study was to conduct pragmatic active TB screening among DM patients in four countries to inform policy. METHODS: DM patients were recruited in Indonesia (n=809), Peru (n=600), Romania (n=603) and South Africa (n=51). TB cases were diagnosed using an algorithm including clinical symptoms and chest X-ray. Presumptive TB patients were examined with sputum smear and culture. RESULTS: A total of 171 (8.3%) individuals reported ever having had TB (South Africa, 26%; Indonesia, 12%; Peru, 7%; Romania, 4%), 15 of whom were already on TB treatment. Overall, 14 (0.73% [95% confidence interval 0.40 to 1.23]) TB cases were identified from screening. Poor glucose control, smoking, lower body mass index, education and socio-economic status were associated with newly diagnosed/current TB. Thirteen of the 14 TB cases diagnosed from this screening would have been found using a symptom-based approach. CONCLUSIONS: These data support the World Health Organization recommendation for routine symptom-based screening for TB in known DM patients in high TB-burden countries. DM patients with any symptoms consistent with TB should be investigated and diagnostic tools should be easily accessible.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Tuberculose Pulmonar
/
Diabetes Mellitus
Tipo de estudo:
Clinical_trials
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Diagnostic_studies
/
Guideline
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Prognostic_studies
/
Screening_studies
Limite:
Humans
País/Região como assunto:
Africa
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America do sul
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Asia
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Europa
/
Peru
Idioma:
En
Revista:
Trans R Soc Trop Med Hyg
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Indonésia
País de publicação:
Reino Unido