Given the well-known linkage between diabetes mellitus (DM) and tuberculosis (TB), the World Health Organization recommends bidirectional screening. Here we report the first screening effort of its kind from a chest clinic in the Ampara district of Sri Lanka. Of 112 TB patients registered between January 2013 and October 2014, 8 had pre-existing DM. Of those remaining, 83 (80%) underwent fasting plasma glucose testing, of whom two (2%) and 17 (20%) were found to have diabetes and impaired fasting glucose, respectively. All of these were enrolled in care. Screening TB patients for DM was found to be feasible at the district level. Further studies at the provincial/country level are required before making any decision to scale up bidirectional screening.
Diabetes mellitus (DM) is an independent risk factor for developing tuberculosis (TB) and for adverse anti-tuberculosis treatment outcomes such as failure, relapse and death. It is estimated that 9 million new TB cases and 1.5 million TB deaths occurred globally in 2013. The burden of DM is increasing worldwide, and concerns have been raised about the emerging co-epidemics of DM and TB, especially in low- to middle-income countries. In 2013, according to the International Diabetes Federation, an estimated 381 million people had DM, a figure that is likely to have doubled by 2030. A study performed in Sri Lanka during 2005 and 2006 found that 10.3% of the population aged ⩾20 years had DM, while 21.8% of the population had some form of dysglycaemia.
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)
W. Rajapakshe, P. Isaakidis, K. D. Sagili, A. M. V. Kumar, S. Samaraweera, N. Pallewatta, W. Jayakody, A. Nissanka (2015) Screening patients with tuberculosis for diabetes mellitus in Ampara, Sri Lanka. Public Health Action vol 5 no 2 10.5588/pha.15.0006
Screening patients with tuberculosis for diabetes mellitus in Ampara, Sri Lanka