Tuberculosis-diabetes screening: how well are we doing? A mixed-methods study from North India

Area of Science:

• Public Health
• Infectious Diseases
• Endocrinology

Background:

• Co-screening for tuberculosis (TB) and diabetes mellitus (DM) is crucial for integrated patient care.
• Implementation gaps exist in bidirectional screening programs within public health facilities.

Purpose of the Study:

• To evaluate the proportion of TB patients screened for DM and vice versa.
• To identify factors, barriers, and enablers influencing screening practices.
• To propose solutions for improving bidirectional screening in Sonipat District, India.

Main Methods:

• A mixed-methods approach combining quantitative (cohort study) and qualitative (interviews) data.
• Analysis of patient records and interviews with patients, healthcare providers (HCPs), and district staff.
• Study conducted in public health facilities in Sonipat District, Haryana, India.

Main Results:

• Bidirectional screening was not implemented; only 24% of TB patients were screened for DM.
• Screening rates were higher in tertiary/secondary centers compared to primary centers.
• Barriers included low patient awareness, poor HCP knowledge, staffing shortages, and inadequate training.

Conclusions:

• Significant deficiencies were found in the implementation of bidirectional TB-DM screening.
• Recommendations include enhancing HCP and patient awareness, providing regular training, ensuring laboratory supplies, and increasing publicity.