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Double trouble: enhancing integrated services for TB and diabetes.
K Jayendran1, M N Williams2, N Shongwe3
1ICAP at Columbia University, Mailman School of Public Health, Columbia University, New York, NY, USA;, Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
Summary
Healthcare providers in Eswatini see the need for better integrated services for tuberculosis (TB) and diabetes mellitus (DM). Improving patient education materials and training are key to better TB-DM care.
Area of Science:
- Public Health
- Infectious Diseases
- Endocrinology
Background:
- Tuberculosis (TB) remains a significant global health issue, disproportionately affecting low- and middle-income countries.
- Diabetes Mellitus (DM) exacerbates the risk of developing active TB, highlighting the need for integrated care strategies.
- The World Health Organization (WHO) advocates for the integration of DM screening and management within TB clinics to enhance patient outcomes.
Purpose of the Study:
- To explore healthcare providers' perspectives on integrating TB-DM services in Eswatini.
- To assess the potential utility of a TB-DM educational pamphlet for patient care.
- To identify barriers and facilitators for effective TB-DM service integration.
Main Methods:
- Development of a TB-DM educational pamphlet in collaboration with stakeholders.
- Conducting in-depth interviews with 17 healthcare providers (HCPs) from urban and rural TB facilities in Manzini, Eswatini.
- Gathering HCPs' insights on integrating TB-DM services and the pamphlet's role.
Main Results:
- Most HCPs felt confident in diagnosing DM among TB patients.
- Key recommendations for improving TB-DM services included enhancing patient education materials, standardizing diagnostic tools, increasing training and mentorship, and improving access to pharmacological information.
- HCPs believed the pamphlet could improve patient and family education and promote adherence to lifestyle changes, with suggestions for simplifying dietary and exercise advice for the local context.
Conclusions:
- Integrated TB-DM services require strengthened diagnostic procedures and expanded training for healthcare providers.
- Enhanced patient education and increased support from nurse mentors are crucial for improving health outcomes in Eswatini.
- Tailoring educational materials to the local context is essential for effective patient engagement and adherence.
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