Evidence map›Paper›PMID 36609325›Full record

ReviewBMJ open2023

Acceptability and feasibility of tuberculosis and diabetes mellitus bidirectional screening and joint treatment services in Malawi: a cross-sectional study and a policy document review.

John Lz Nyirenda, Erasmo Mbemba, Marumbo Chirwa, Balwani Mbakaya, Bagrey Ngwira, Dirk Wagner, Ingrid Toews, Berit Lange

Open access · goldAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 5 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 2 countries.

John Lz NyirendaDivision of Infectious Diseases, Department of Internal Medicine II (Gastroenterology, Hepatology, Endocrinology, and Infectiology), University Hospital Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany jonnyirenda@gmail.com.ORCID 0000-0003-0851-712X
Erasmo MbembaPublic Health Department, Faculty of Applied Sciences, University of Livingstonia, Mzuzu, Malawi.
Marumbo ChirwaPublic Health Department, Faculty of Applied Sciences, University of Livingstonia, Mzuzu, Malawi.
Balwani MbakayaPublic Health Department, Faculty of Applied Sciences, University of Livingstonia, Mzuzu, Malawi.
Bagrey NgwiraEnvironmental Health Department, Faculty of Applied Sciences, Malawi University of Business and Applied Sciences, Blantyre, Malawi.
Dirk WagnerDivision of Infectious Diseases, Department of Internal Medicine II (Gastroenterology, Hepatology, Endocrinology, and Infectiology), University Hospital Freiburg, Medical Faculty, University of Freiburg, Freiburg, Germany.
Ingrid ToewsInstitute for Evidence in Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.ORCID 0000-0001-6955-9695
Berit LangeEpidemiology Department, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany.
University of Freiburg · DEUniversity of Livingstonia · MWGerman Center for Infection Research · DEUniversity of Malawi · MW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesA cross-sectional and a policy document review study was performed to investigate perceived acceptability and feasibility to implementing different integration measures for tuberculosis (TB) and diabetes mellitus (DM) healthcare among healthcare workers (HCWs) and health managers, and to describe policy influence through a policy documents review in Malawi.

settingThe survey was performed at eight hospitals, ministry of health offices and 10 non-governmental organisations. We collected data in March and April 2021.

participantsOf 95 HCWs and health managers invited; 92 participated. 21/92 (23%) were female, and 17/92 (18%) participants were from clinics that piloted the integrated care for TB and DM. OUTCOME MEASURES: We described awareness levels on TB/DM comorbidity, perceptions and experiences in TB/DM care. Furthermore, development processes and contents of included documents were analysed.

results16/17 (94%) of HCWs from clinics piloting integrated care and 65/75 (86%) HCWs from hospitals that do not use integrated care for TB and DM responded that integrated care was acceptable and feasible. In qualitative data, shortage of resources, inadequate information sharing were common themes. We included seven relevant documents for the analysis. On development process and content, six of seven documents were scored ≥70%. In these documents, DM is a recognised risk factor for TB, and integration of healthcare services for infectious diseases and non-communicable diseases is recommended, however, these documents lacked information specifically on integrated care for TB and DM.

conclusionIn this study, we identified inadequate information sharing, and lack of resources as major factors impeding implementation of integration of services, however, awareness on TB/DM comorbidity was high.

Indexed as

Diabetes MellitusTuberculosisCross-Sectional StudiesFeasibility StudiesFemaleHumansMalawiMaleMass ScreeningPolicyGeneral diabetesHealth policyOrganisation of health servicesPRIMARY CAREPUBLIC HEALTHTuberculosis

Identifiers

PMID36609325
PMCPMC9827251
OpenAlexW4313641756

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.