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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 |
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