dc.contributor.author |
Grint, Daniel |
|
dc.contributor.author |
Alisjhabana, Bachti |
|
dc.contributor.author |
Ugarte Gil, Cesar Augusto |
|
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 Alexander James |
|
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 |
https://hdl.handle.net/20.500.12866/3940 |
|
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. |
en_US |
dc.language.iso |
eng |
|
dc.publisher |
World Health Organization |
|
dc.relation.ispartofseries |
Bulletin of the 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 |
en_US |
dc.subject |
Diabetes Mellitus |
en_US |
dc.subject |
Diabetes Mellitus--diagnóstico |
en_US |
dc.title |
Accuracy of diabetes screening methods used for people with tuberculosis, Indonesia, Peru, Romania, South Africa |
en_US |
dc.type |
info:eu-repo/semantics/article |
|
dc.identifier.doi |
https://doi.org/10.2471/BLT.17.206227 |
|
dc.subject.ocde |
https://purl.org/pe-repo/ocde/ford#3.03.05 |
|
dc.relation.issn |
1564-0604 |
|