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Screening tuberculosis patients for diabetes in a tribal area in South India.

SETTING
Ten peripheral health institutions of a tribal tuberculosis unit, Saluru, Vizianagaram District, South India.


OBJECTIVE
To assess among tuberculosis (TB) patients: 1) the feasibility of screening for diabetes mellitus (DM), 2) the prevalence of DM, 3) the demographic and clinical features associated with DM, and 4) the number needed to screen (NNS) to find one new case of DM.


DESIGN
Cross-sectional study: all TB patients registered from January to September 2012 were screened for DM using a screening questionnaire and random blood glucose, followed by fasting blood glucose (FBG) measurements using a glucometer. DM was diagnosed if FBG was ≥126 mg/dl.


RESULTS
Of 381 patients, 374 (98%) were assessed for DM, suggesting feasibility of screening, and 19 (5%) were found to have DM (12 were newly diagnosed and 7 had a previous diagnosis of DM). The only characteristic associated with DM was age ≥40 years. The NNS to detect a new case of DM among all TB patients was 31; among those aged ≥40 years, the NNS was 20, and among current smokers it was 21.


CONCLUSION
Screening of TB patients for DM was feasible and effective, and this should inform national scale-up. Other key considerations include the continued provision of free TB-DM screening, with co-location and integration of services.