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Accuracy of diabetes screening methods used for people with tuberculosis, Indonesia, Peru, Romania, South Africa

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dc.contributor.author Grint, Daniel
dc.contributor.author Alisjhabana, Bachti
dc.contributor.author Ugarte-Gil, Cesar
dc.contributor.author Riza, Anca-Leila
dc.contributor.author Walzl, Gerhard
dc.contributor.author Pearson, Fiona
dc.contributor.author Ruslami, Rovina
dc.contributor.author Moore, David A. J.
dc.contributor.author Ioana, Mihai
dc.contributor.author McAllister, Susan
dc.contributor.author Ronacher, Katharina
dc.contributor.author Koeseomadinata, Raspati C.
dc.contributor.author Kerry-Barnard, Sarah R.
dc.contributor.author Coronel, Jorge
dc.contributor.author Malherbe, Stephanus T.
dc.contributor.author Dockrell, Hazel M.
dc.contributor.author Hill, Philip C.
dc.contributor.author Van Crevel, Reinout
dc.contributor.author Critchley, Julia A.
dc.date.accessioned 2018-11-08T19:39:21Z
dc.date.available 2018-11-08T19:39:21Z
dc.date.issued 2018
dc.identifier.uri http://doi.org/10.2471/BLT.17.206227
dc.identifier.uri http://repositorio.upch.edu.pe/handle/upch/3940
dc.description.abstract Objective To evaluate the performance of diagnostic tools for diabetes mellitus, including laboratory methods and clinical risk scores, in newly-diagnosed pulmonary tuberculosis patients from four middle-income countries. Methods In a multicentre, prospective study, we recruited 2185 patients with pulmonary tuberculosis from sites in Indonesia, Peru, Romania and South Africa from January 2014 to September 2016. Using laboratory-measured glycated haemoglobin (HbA1c) as the gold standard, we measured the diagnostic accuracy of random plasma glucose, point-of-care HbA1c, fasting blood glucose, urine dipstick, published and newly derived diabetes mellitus risk scores and anthropometric measurements. We also analysed combinations of tests, including a two-step test using point-of-care HbA1cwhen initial random plasma glucose was ≥6.1 mmol/L. Findings The overall crude prevalence of diabetes mellitus among newly diagnosed tuberculosis patients was 283/2185 (13.0%; 95% confidence interval, CI: 11.6–14.4). The marker with the best diagnostic accuracy was point-of-care HbA1c (area under receiver operating characteristic curve: 0.81; 95% CI: 0.75–0.86). A risk score derived using age, point-of-care HbA1c and random plasma glucose had the best overall diagnostic accuracy (area under curve: 0.85; 95% CI: 0.81–0.90). There was substantial heterogeneity between sites for all markers, but the two-step combination test performed well in Indonesia and Peru. Conclusion Random plasma glucose followed by point-of-care HbA1c testing can accurately diagnose diabetes in tuberculosis patients, particularly those with substantial hyperglycaemia, while reducing the need for more expensive point-of-care HbA1c testing. Risk scores with or without biochemical data may be useful but require validation.
dc.language.iso eng
dc.publisher World Health Organization
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Tuberculosis
dc.subject Diabetes Mellitus
dc.subject Diabetes Mellitus--diagnóstico
dc.title Accuracy of diabetes screening methods used for people with tuberculosis, Indonesia, Peru, Romania, South Africa
dc.type info:eu-repo/semantics/article
dc.identifier.journal Bulletin of the World Health Organization

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