Tuberculosis (TB) remains a major global public health threat. According to the most recent World Health Organization (WHO) Global TB Report, in 2015, an estimated 10.4 million people developed active TB and 1.8 million people were estimated to have died from the disease. In the last decade, the world has also witnessed an escalating epidemic of diabetes mellitus (DM) which has arisen as a consequence of population growth, aging, urbanization and changes in lifestyle. Available data suggest that an estimated 415 million people worldwide live with DM and another 318 million people have impaired glucose tolerance. By 2040, these numbers will grow to 642 million and 481 million, respectively. ObjectivesTo develop a practical TB-DM guide for health care workers in low and middle income countries.
The World Diabetes Foundation (WDF), the International Union Against Tuberculosis and Lung Disease (The Union), the World Health Organization (WHO) and its partners have built a strong base of evidence to show that tuberculosis and diabetes are epidemiologically linked. TB-diabetes is still a relatively new area in the global health arena, and in the past 5 years, a number of countries have implemented collaborative activities between TB and DM/non-communicable diseases (NCD) programs, including bi-directional screening.Whilst the Union-WHO Collaborative Framework (2011) provides an effective conceptualisation for addressing the dual epidemic, targeting decision makers and public health in general, it does not provide practical information and guidance for programmatic roll out at country level, nor does it include the core components of necessary training programmes for health care workers. Through this project, a new guide is to be developed in order to address this gap of operationalisation. Awareness about the interaction between DM and TB is improving among front-line health staff, which makes it important that they have a guideline to assist them with treatment, prevention and care for TB- DM patients. Such a guide, in straightforward, accessible language will be a vital tool for health workers implementing routine DM TB services in various settings, but notably in low and middle income countries.
• TB-DM guide developed and distributed through printed copies and free electronic online access:DM-TB_Guide English: https://theunion.org/sites/default/files/2020-11/TheUnion_DMTB_Guide.pdfDM-TB_Guide_French: https://theunion.org/sites/default/files/2020-08/TheUnion_DMTB_Guide_FR.pdfDM-TB_Guide_Chinese: https://theunion.org/sites/default/files/2020-08/DM-TB-guide-Chinese.pdf• Printing included 1,200 copies in English and 1,500 copies Chinese and 500 in French.• TB-DM guide piloted in three health centres/hospitals in two countries (Pakistan and Zimbabwe).