By The
Union
The
Union has been providing technical support to the United States Agency for
International Development (USAID) Control and Prevention-Tuberculosis (CAP-TB)
project in China, a five-year project designed to improve case detection and
treatment for multidrug-resistant TB (MDR-TB) in the Greater Mekong Sub-Region
of China, Myanmar and Thailand. One of the components of the project, which
began in 2011, has been to detect TB earlier in high-risk groups, such as
people with diabetes mellitus.
An
earlier Union study in China and India demonstrated that bidirectional
screening of patients for TB and DM in a hospital setting was both feasible and
effective. The goal of this new project, in addition to detecting cases, was to
determine if the same screening model would work well in community health
settings.
In
partnership with USAID’s implementing partner, FHI 360, and Yunnan Provincial
Anti-TB Association, 10 community health centres in urban and rural areas of
the Xishan District of Yunnan Province were selected and the staff trained to
conduct the TB screening. During the
project period (June 2013-April 2014), 2,942 patients with diabetes visited
these clinics. Of them, two were already known to have TB, and 278 (9.5 percent)
proved to have positive TB symptoms and were sent for further treatment. One
person was diagnosed with active TB and started on anti-TB treatment. Although
this number is small, the rate of diagnosis is nearly three times higher than
that found in the general population in Yunnan.
This
study, which was based on the WHO-Union Collaborative Framework for the Care
and Control of TB and Diabetes (2011), is significant because China has the
second largest number of TB cases in the world – with close to 900,000 cases
reported to the World Health Organization in 2012 – and an estimated 113.9
million adults with diabetes. With
research showing that people with diabetes mellitus are more than three times
more likely to develop active TB than people without diabetes, effective
cross-screening of these populations is essential to reducing the impact of
both diseases.
Funding
for the CAP-TB project was provided by USAID. Results of the TB-diabetes study
have been accepted for publication in Tropical Medicine and International
Health.
Source: The Union.
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