Is screening for diabetes among tuberculosis patients feasible at the field level?
Is screening for diabetes among tuberculosis patients feasible at the field level?
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DOI：
10.5588/pha.13.0022
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发表时间：
2013-11-04
影响因子：
1.4
通讯作者：
Harries, A. D.
中科院分区：
文献类型：
--
作者：
Naik, B.;Kumar, A. M. V.;Harries, A. D.
单位：印度南部科拉区(人口50万)的17家外围卫生机构(PHI)。目的：评估在外围水平筛查结核病(TB)患者糖尿病(DM)的可行性和结果。设计：2012年1月至9月，对所有结核病患者进行DM筛查。每个PHI的训练有素的实验室技术人员使用国家方案提供的毛细血管血样血糖仪，对不明原因的糖尿病患者进行疾病筛查(免费)。结果：362例肺结核患者中，358例(99%)确诊为糖尿病，62例(17.1%)有糖尿病，53例(14.6%)有糖尿病既往病史，9例(2.9%)为新诊断。所有新的糖尿病患者都加入了糖尿病护理。40岁的结核病患者、吸烟者和涂阳肺结核患者的糖尿病患病率较高。要发现一例新的糖尿病患者，需要在结核病患者中筛查40个(NNS)。结论：在外围环境中筛查结核病患者的DM是可行和有效的。每个公共基础设施都有训练有素的实验室技术人员和免费服务，这使得干预是可行的。这项研究有助于在这方面作出国家政策决定。
Setting: Seventeen peripheral health institutions (PHI) in Kolar district (population: 0.5 million), South India.Objective: To assess the feasibility and results of screening patients with tuberculosis (TB) for diabetes mellitus (DM) at peripheral level.Design: From January to September 2012, all TB patients were assessed for DM. Those with unknown DM status were screened for the disease (free of charge) by trained laboratory technicians at each PHI, using a glucometer supplied by the national programme on a capillary blood sample. Those with fasting blood glucose (FBG) >= 126 mg/dl (>= 7 mM) were diagnosed as DM-positive.Results: Of 362 TB patients, 358 (99%) were assessed for DM and 62 (17.1%) had the diseases-53 (14.6%) had a previous history of DM and 9 (2.9%) were newly diagnosed. All new DM patients were enrolled into DM care. Higher DM prevalence was found among TB patients aged >= 40 years, smokers and those with smear-positive pulmonary TB. To detect a new case of DM, the number needed to screen (NNS) among TB patients was 40.Conclusion: Screening of TB patients for DM was feasible and effective in a peripheral setting. The availability of trained laboratory technicians and free services at every PHI made the intervention feasible. The study has contributed towards a national policy decision in this regard.