Universidad Peruana Cayetano Heredia

Point of care HbA(1c) level for diabetes mellitus management and its accuracy among tuberculosis patients: a study in four countries

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dc.contributor.author Huangfu, P.
dc.contributor.author Laurence, Y.V.
dc.contributor.author Alisjahbana, B.
dc.contributor.author Ugarte Gil, Cesar Augusto
dc.contributor.author Riza, A.-L.
dc.contributor.author Walzl, G.
dc.contributor.author Ruslami, R.
dc.contributor.author Moore, David Alexander James
dc.contributor.author Ioana, M.
dc.contributor.author McAllister, S.
dc.contributor.author Ronacher, K.
dc.contributor.author Koesoemadinata, R.C.
dc.contributor.author Grint, D.
dc.contributor.author Kerry, S.
dc.contributor.author Coronel, J.
dc.contributor.author Malherbe, S.T.
dc.contributor.author Griffiths, U.
dc.contributor.author Dockrell, H.M.
dc.contributor.author Hill, P.C.
dc.contributor.author Van Crevel, R.
dc.contributor.author Pearson, F.
dc.contributor.author Critchley, J.A.
dc.date.accessioned 2019-12-06T20:57:49Z
dc.date.available 2019-12-06T20:57:49Z
dc.date.issued 2019
dc.identifier.uri https://hdl.handle.net/20.500.12866/7437
dc.description.abstract BACKGROUND: Diabetes mellitus (DM) is common among tuberculosis (TB) patients and often undiagnosed or poorly controlled. We compared point of care (POC) with laboratory glycated haemoglobin (HbA1c) testing among newly diagnosed TB patients to assess POC test accuracy, safety and acceptability in settings in which immediate access to DM services may be difficult. METHODS : We measured POC and accredited laboratory HbA1c (using high-performance liquid chromatography) in 1942 TB patients aged ≫18 years recruited from Peru, Romania, Indonesia and South Africa. We calculated overall agreement and individual variation (mean 6 2 standard deviations) stratified by country, age, sex, body mass index (BMI), HbA1c level and comorbidities (anaemia, human immunodeficiency virus [HIV]). We used an error grid approach to identify disagreement that could raise significant concerns. R E SULT S : Overall mean POC HbA1c values were modestly higher than laboratory HbA1c levels by 0.1% units (95%CI 0.1-0.2); however, there was a substantial discrepancy for those with severe anaemia (1.1% HbA1c, 95%CI 0.7-1.5). For 89.6% of 1942 patients, both values indicated the same DM status (no DM, HbA1c ,6.5%) or had acceptable deviation (relative difference ,6%). Individual agreement was variable, with POC values up to 1.8% units higher or 1.6% lower. For a minority, use of POC HbA1c alone could result in error leading to potential overtreatment (n = 40, 2.1%)or undertreatment (n = 1, 0.1%). The remainder had moderate disagreement, which was less likely to influence clinical decisions. CONCLUSION: POC HbA1c is pragmatic and sufficiently accurate to screen for hyperglycaemia and DM risk among TB patients. © 2019 The Union. en_US
dc.language.iso eng
dc.publisher International Union Against Tuberculosis and Lung Disease
dc.relation.ispartofseries International Journal of Tuberculosis and Lung Disease
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject adult en_US
dc.subject age en_US
dc.subject anemia en_US
dc.subject Article en_US
dc.subject body mass en_US
dc.subject diabetes mellitus en_US
dc.subject diagnostic accuracy en_US
dc.subject diagnostic error en_US
dc.subject disease severity en_US
dc.subject DM en_US
dc.subject Epidemiology en_US
dc.subject female en_US
dc.subject HbA1c en_US
dc.subject hemoglobin A1c en_US
dc.subject hemoglobin blood level en_US
dc.subject high performance liquid chromatography en_US
dc.subject human en_US
dc.subject Human immunodeficiency virus en_US
dc.subject hyperglycemia en_US
dc.subject infection risk en_US
dc.subject Likert scale en_US
dc.subject major clinical study en_US
dc.subject male en_US
dc.subject middle aged en_US
dc.subject middle income country en_US
dc.subject patient safety en_US
dc.subject point of care testing en_US
dc.subject prevalence en_US
dc.subject priority journal en_US
dc.subject public health en_US
dc.subject Public health en_US
dc.subject screening en_US
dc.subject Screening en_US
dc.subject sex en_US
dc.subject TB en_US
dc.subject treatment refusal en_US
dc.subject tuberculosis en_US
dc.title Point of care HbA(1c) level for diabetes mellitus management and its accuracy among tuberculosis patients: a study in four countries en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.5588/ijtld.18.0359
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.07
dc.relation.issn 1815-7920


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