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Screening diabetes mellitus patients for pulmonary tuberculosis: a multisite study in Indonesia, Peru, Romania and South Africa

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dc.contributor.author Alisjahbana, Bachti
dc.contributor.author McAllister, Susan M.
dc.contributor.author Ugarte Gil, Cesar Augusto
dc.contributor.author Mircea-Panduru, Nicolae
dc.contributor.author Ronacher, Katharina
dc.contributor.author Koesoemadinata, Raspati C.
dc.contributor.author Zubiate, Carlos
dc.contributor.author Lelia-Riza, Anca
dc.contributor.author Malherbe, Stephanus T.
dc.contributor.author Kleynhans, Leanie
dc.contributor.author López, Sonia
dc.contributor.author Dockrell, Hazel M.
dc.contributor.author Ruslami, Rovina
dc.contributor.author Ioana, Mihai
dc.contributor.author Walzl, Gerhard
dc.contributor.author Pearson, Fiona
dc.contributor.author Critchley, Julia A.
dc.contributor.author Moore, David Alexander James
dc.contributor.author van Crevel, Reinout
dc.contributor.author Hill, Philip C.
dc.date.accessioned 2021-06-08T15:46:14Z
dc.date.available 2021-06-08T15:46:14Z
dc.date.issued 2021
dc.identifier.uri https://hdl.handle.net/20.500.12866/9509
dc.description.abstract BACKGROUND: Diabetes mellitus (DM) patients are three times more likely to develop tuberculosis (TB) than the general population. Active TB screening in people with DM is part of a bidirectional approach. The aim of this study was to conduct pragmatic active TB screening among DM patients in four countries to inform policy. METHODS: DM patients were recruited in Indonesia (n=809), Peru (n=600), Romania (n=603) and South Africa (n=51). TB cases were diagnosed using an algorithm including clinical symptoms and chest X-ray. Presumptive TB patients were examined with sputum smear and culture. RESULTS: A total of 171 (8.3%) individuals reported ever having had TB (South Africa, 26%; Indonesia, 12%; Peru, 7%; Romania, 4%), 15 of whom were already on TB treatment. Overall, 14 (0.73% [95% confidence interval 0.40 to 1.23]) TB cases were identified from screening. Poor glucose control, smoking, lower body mass index, education and socio-economic status were associated with newly diagnosed/current TB. Thirteen of the 14 TB cases diagnosed from this screening would have been found using a symptom-based approach. CONCLUSIONS: These data support the World Health Organization recommendation for routine symptom-based screening for TB in known DM patients in high TB-burden countries. DM patients with any symptoms consistent with TB should be investigated and diagnostic tools should be easily accessible en_US
dc.language.iso eng
dc.publisher Oxford University Press
dc.relation.ispartofseries Transactions of the Royal Society of Tropical Medicine and Hygiene
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 screening en_US
dc.subject diabetes mellitus en_US
dc.title Screening diabetes mellitus patients for pulmonary tuberculosis: a multisite study in Indonesia, Peru, Romania and South Africa en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1093/trstmh/traa100
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.06
dc.relation.issn 1878-3503


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