ArticleBMC infectious diseases2022
Bidirectional screening and treatment outcomes of diabetes mellitus (DM) and Tuberculosis (TB) patients in hospitals with measures to integrate care of DM and TB and those without integration measures in Malawi.
Article in BMC infectious diseases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- Association between maintenance dialysis and tuberculosis treatment outcomes in Amazonas, Brazil: a population-based record-linkage cohort study (2001-2023) : Maintenance Dialysis and Tuberculosis Outcomes.BMC infectious diseases · 2026Article
- From silos to synergy: assessing tuberculosis basic management units readiness for integrated diabetes mellitus care across different districts of Pakistan.Primary health care research & development · 2026Article
- The integration of communicable and non-communicable disease (CD-NCD) health services in Africa: A scoping review.PLOS global public health · 2026Article
- Influence of Diabetes Mellitus on the Development of Multidrug-Resistant Tuberculosis (MDR-TB) in Relation With Genetic Mutations ofThe Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2026Article
- Article
- Implementation of hospital-initiated complex interventions for adult people with multiple long-term conditions: a scoping review.BMC health services research · 2025Article
- TB and diabetes in Eswatini: Addressing suboptimal treatment outcomes through integrated services.PLOS global public health · 2025Article
- Inflammatory Markers as Predictors of Diabetes Mellitus in Patients with Pulmonary Tuberculosis: A Retrospective Analysis of Hematological Parameters and Clinical Features.Diabetes, metabolic syndrome and obesity : targets and therapy · 2025Article
- Addressing the challenge of tuberculosis screening in diabetic populations: a narrative review of methods and strategies.Frontiers in public health · 2025Review
- The collaborative framework for the management of tuberculosis and type 2 diabetes syndemic in low- and middle-income countries: a rapid review.BMC public health · 2024Review
- Tackling syndemics by integrating infectious and noncommunicable diseases in health systems of low- and middle-income countries: A narrative systematic review.PLOS global public health · 2024Article
- Diabetes-Tuberculosis Care in Eswatini: A Qualitative Study of Opportunities and Recommendations for Effective Services Integration.International journal of public health · 2023Article
- Potential and challenges for an integrated management of tuberculosis, diabetes mellitus, and hypertension: A scoping review protocol.PloS one · 2022Article
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4 authors.
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Abstract
introductionThere are efforts in low and middle-income countries (LMICs) to integrate Tuberculosis (TB) and Diabetes mellitus (DM) healthcare services, as encouraged by WHO and other international health organizations. However, evidence on actual effect of different integration measures on bidirectional screening coverages and or treatment outcomes for both diseases in LMICs is scarce. OBJECTIVES AND
methodsRetrospective chart review analysis was conducted to determine effects of integrated care on bidirectional screening and treatment outcomes for both TB patients and people with DM (PWD) recruited in eight Malawian hospitals. Data of ≥ 15 years old patients registered between 2016 to August 2019 were collected and analysed.
results557 PWDs (mean age 54) and 987 TB patients (mean age 41) were recruited. 64/557 (11.5%) PWDs and 105/987 (10.6%) of TB patients were from an integrating hospital. 36/64 (56.3%) PWDs were screened for TB in integrated healthcare as compared to 5/493 (1.0%) in non-integrated care; Risk Difference (RD) 55.2%, (95%CI 43.0, 67.4), P < 0.001, while 10/105 (9.5%) TB patients were screened for DM in integrated healthcare as compared to 43/882 (4.9%) in non-integrated care; RD 4.6%, (95%CI - 1.1, 10.4), P = 0.065. Of the PWDs screened, 5/41 (12.2%) were diagnosed with TB, while 5/53 (9.4%) TB patients were diagnosed with DM. On TB treatment outcomes, 71/508 (14.8%) were lost to follow up in non-integrated care and none in integrated care were lost to follow-up; RD - 14.0%, (95%CI: - 17.0,-11.0), p < 0.001. Among PWDs, 40/493 (8.1%) in non-integrated care and 2/64 (3.1%) were lost to follow up in integrated care; RD - 5.0%, (95%CI:-10.0, - 0.0); P = 0.046. After ≥ 2 years of follow up, 62.5% PWDs in integrated and 41.8% PWDs in non-integrated care were retained in care, RD 20.7, (95%CI: 8.1, 33.4), P = 0.001.
conclusionWe found higher bidirectional screening coverage and less loss to follow-up in one centre that made more efforts to implement integrated measures for TB and DM care than in 7 others that did not make these efforts. Decisions on local programs to integrate TB/DM care should be taken considering currently rather weak evidence and barriers faced in the local context as well as existing guidelines.
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