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

Majumdar, Anindo
; 
Wilkinson, Ewan
; 
Rinu, P. Krishnankutty
; 
Maung, Thae Maung
; 
Bachani, Damodar
; 
Punia, Jaswant Singh
; 
Jain, Shalu
; 
Yadav, Taramani
; 
Jarhyan, Prashant
; 
Mohan, Sailesh
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Affiliation
All India Institute of Medical Sciences; University of Chester; Public Health Foundation of India; Ministry of Health and Sports, Myanmar; John Snow India Pvt Ltd; Haryana Health Department, India; Haryana District Tuberculosis Office, Revised National Tuberculosis Control Programme; International Union Against Tuberculosis and Lung Disease (The Union); Yenepoya Medical College, Yenepoya (Deemed University)
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2019-03-21
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Health and Social Care
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Abstract
Setting: Public health care facilities in Sonipat District, Haryana State, India. Objectives: To assess 1) the proportion of tuberculosis (TB) patients screened for diabetes mellitus (DM) and vice versa, 2) factors associated with screening, and 3) the enablers, barriers and solutions related to screening. Design: A mixed-methods study with quantitative (cohort study involving record reviews of patients registered between November 2016 and April 2017) and qualitative (interviews of patients, health care providers [HCPs] and key district-level staff) components. Results: Screening for TB among DM patients was not implemented, despite documents indicating that it had been. Of 562 TB patients, only 137 (24%) were screened for DM. TB patients registered at tertiary and secondary health centres were more likely to be screened than primary health centres. Low patient awareness, poor knowledge of guidelines among HCPs, lack of staff and inadequate training were barriers to screening. Enablers were the positive attitude of HCPs and programme staff. The key solutions suggested were to improve awareness of HCPs and patients regarding the need for screening, training of HCPs and wider availability of DM testing facilities. Conclusion: The implementation of bidirectional screening was poor. Adequate staffing, regular training, continuous laboratory supplies for DM diagnosis and widespread publicity should be ensured.
Citation
Majumdar, A., Wilkinson, E., Rinu, P. K., Maung, T. M., Bachani, D., Punia, J. S., ... & Kumar, A. M. V. (2019). Tuberculosis-diabetes screening: how well are we doing? A mixed-methods study from North India. Public Health Action, 9(1), 3-10. https://doi.org/10.5588/pha.18.0048
Publisher
International Union Against Tuberculosis and Lung Disease
Journal
Public Health Action
Research Unit
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http://hdl.handle.net/10034/628009
DOI
10.5588/pha.18.0048
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Article
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2220-8372
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https://www.ingentaconnect.com/content/iuatld/pha/2019/00000009/00000001/art00003