This study set out to assess the feasibility, results and challenges of
screening patients with diabetes mellitus (DM) for tuberculosis (TB)
within the healthcare setting of six DM clinics in tertiary hospitals
Agreement on how to screen, monitor and record the screening was reached
in October 2011 at a national stakeholders' meeting, and training was
carried out for staff in the six tertiary care facilities in December
2011. Implementation started in the first quarter of 2012, and the
authors report on activities up to 30th September 2012. Patients with DM
were screened for TB on each clinic attendance using a symptom-based
enquiry, and those with positive symptoms were referred for TB
In the three quarters, 26% of 7218, 52% of 12237 and 48% of 11691
patients with DM were screened for TB. A total of 254 patients were
identified with TB, of whom 46% had smear-positive pulmonary disease.
There were 18 patients newly diagnosed with TB as a result of screening
and referral, with the remainder being patients already diagnosed from
elsewhere. TB case rates per 100 000 patients attending the DM clinic
each quarter were 859, 956 and 642. Almost 90% of patients with TB were
recorded as starting or being on anti-TB treatment. Major implementation
challenges related to human resources and recording systems.
In India, it is feasible to screen patients with DM for TB resulting in
high rates of TB detection. More attention to detail, human resource
requirements and electronic medical records are needed to improve
India Diabetes Mellitus &#8211; Tuberculosis Study Group. Screening of patients with diabetes mellitus for tuberculosis in India. Tropical Medicine and International Health (2013) 18 (5) 646-654. [DOI: 10.1111/tmi.12083]
Screening of patients with diabetes mellitus for tuberculosis in India.