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Published in: BMC Public Health 1/2024

Open Access 01-12-2024 | Tuberculosis | Research

The collaborative framework for the management of tuberculosis and type 2 diabetes syndemic in low- and middle-income countries: a rapid review

Authors: Denise Michela Milice, Ivalda Macicame, José L.Peñalvo

Published in: BMC Public Health | Issue 1/2024

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Abstract

Introduction

Given the absence of international guidelines on the joint management and control of tuberculosis (TB) and type 2 diabetes mellitus (T2D), the World Health Organization (WHO) and the International Union Against Tuberculosis and Lung Disease (The Union) launched in 2011 a policy framework to address the growing syndemic burden of TB-T2D. This review aimed at mapping the available evidence on the implementation of the Union-WHO Framework, explicitly, or bi-directional TB-T2D health programs as an initiative for co-management in patients in low- and middle-income countries (LMIC).

Methods

A rapid review was performed based on a systematic search in PubMed and Web of Science electronic databases for peer-reviewed articles on The Union-WHO Framework and bi-directional interventions of TB and T2D in LMIC. The search was restricted to English language articles and from 01/08/2011 to 20/05/2022.

Results

A total of 24 articles from 16 LMIC met the inclusion criteria. Four described the implementation of The Union-WHO Framework and 20 on the bi-directional interventions of TB and T2D. Bi-directional activities were found valuable, feasible and effective following the Union-WHO recommendations. Limited knowledge and awareness on TB-T2D comorbidity was identified as one of the barriers to ensure a functional and effective integration of services.

Conclusions

This review revealed that it is valuable, feasible and effective to implement bi-directional TB and T2D activities (screening and management) according to the Union-WHO Framework recommendations, especially in countries that face TB-T2D syndemic. Additionally, it was apparent that gaps still exist in research aimed at providing evidence of costs to implement collaborative activities. There is need for TB and T2D services integration that should be done through the well-stablished TB programme. This integration of two vertical programmes, could ensure patient-centeredness, continuum of care and ultimately contribute for health systems strengthening.
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Literature
2.
go back to reference World Health Organization. Global tuberculosis report 2023. Geneva: World Health Organization; 2016. p. 59. World Health Organization. Global tuberculosis report 2023. Geneva: World Health Organization; 2016. p. 59.
3.
go back to reference International Diabetes Federation. IDF diabetes atlas 2021. 10th Edition. Brussels: International Diabetes Federation; 2021. p. 141. International Diabetes Federation. IDF diabetes atlas 2021. 10th Edition. Brussels: International Diabetes Federation; 2021. p. 141.
4.
go back to reference Mendenhall E, Kohrt BA, Norris SA, Ndetei D, Prabhakaran D. Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. Lancet. 2017;389:951–63.CrossRefPubMedPubMedCentral Mendenhall E, Kohrt BA, Norris SA, Ndetei D, Prabhakaran D. Non-communicable disease syndemics: poverty, depression, and diabetes among low-income populations. Lancet. 2017;389:951–63.CrossRefPubMedPubMedCentral
6.
go back to reference Singer M, Snipes C. Generations of Suffering: Experiences of a treatment Program for Substance Abuse During Pregnancy. J Health Care Poor Underserved. 1992;3:222–34.CrossRefPubMed Singer M, Snipes C. Generations of Suffering: Experiences of a treatment Program for Substance Abuse During Pregnancy. J Health Care Poor Underserved. 1992;3:222–34.CrossRefPubMed
7.
go back to reference S Merrill 2009 ) Introduction to Syndemics: A Critical Systems Approach to Public and Community Health 1 Jossey-Bass A Willey Imprint San Francisco S Merrill 2009 ) Introduction to Syndemics: A Critical Systems Approach to Public and Community Health 1 Jossey-Bass A Willey Imprint San Francisco
9.
go back to reference Alebel A, Wondemagegn AT, Tesema C, Kibret GD, Wagnew F, Petrucka P et al. Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: A systematic review and meta-analysis of observational studies. BMC Infectious Diseases 2019;19. https://doi.org/10.1186/s12879-019-3892-8. Alebel A, Wondemagegn AT, Tesema C, Kibret GD, Wagnew F, Petrucka P et al. Prevalence of diabetes mellitus among tuberculosis patients in Sub-Saharan Africa: A systematic review and meta-analysis of observational studies. BMC Infectious Diseases 2019;19. https://​doi.​org/​10.​1186/​s12879-019-3892-8.
10.
go back to reference Kapur A, Harries AD, Lönnroth K, Wilson P, Sulistyowati LS. Diabetes and tuberculosis co-epidemic: The Bali Declaration. Lancet Diabetes Endocrinol. 2016;4:8–10.CrossRefPubMed Kapur A, Harries AD, Lönnroth K, Wilson P, Sulistyowati LS. Diabetes and tuberculosis co-epidemic: The Bali Declaration. Lancet Diabetes Endocrinol. 2016;4:8–10.CrossRefPubMed
11.
12.
go back to reference Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Med. 2008;5:1091–101. Jeon CY, Murray MB. Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Med. 2008;5:1091–101.
13.
go back to reference Lee MR, Huang YP, Kuo YT, Luo CH, Shih YJ, Shu CC, et al. Diabetes Mellitus and Latent Tuberculosis Infection: A Systemic Review and Metaanalysis. Clin Infect Dis. 2017;64:719–27.PubMed Lee MR, Huang YP, Kuo YT, Luo CH, Shih YJ, Shu CC, et al. Diabetes Mellitus and Latent Tuberculosis Infection: A Systemic Review and Metaanalysis. Clin Infect Dis. 2017;64:719–27.PubMed
14.
go back to reference Faurholt-Jepsen D, Range N, Praygod G, Jeremiah K, Faurholt-Jepsen M, Aabye MG, et al. Diabetes is a strong predictor of mortality during tuberculosis treatment: A prospective cohort study among tuberculosis patients from Mwanza Tanzania. Trop Med Int Health. 2013;18:822–9.CrossRefPubMed Faurholt-Jepsen D, Range N, Praygod G, Jeremiah K, Faurholt-Jepsen M, Aabye MG, et al. Diabetes is a strong predictor of mortality during tuberculosis treatment: A prospective cohort study among tuberculosis patients from Mwanza Tanzania. Trop Med Int Health. 2013;18:822–9.CrossRefPubMed
15.
go back to reference The International Union Against Tuberculosis and Lung Disease; World Health Organization. Collaborative framework for care and control of tuberculosis and diabetes. Paris: The International Union Against Tuberculosis and Lung Disease; Geneva: World Health Organization; 2011. p. 35. The International Union Against Tuberculosis and Lung Disease; World Health Organization. Collaborative framework for care and control of tuberculosis and diabetes. Paris: The International Union Against Tuberculosis and Lung Disease; Geneva: World Health Organization; 2011. p. 35.
16.
go back to reference Lönnroth K. Colliding epidemics requires collaborating programmes. Lancet Diabetes Endocrinol. 2015;3:306–7.CrossRefPubMed Lönnroth K. Colliding epidemics requires collaborating programmes. Lancet Diabetes Endocrinol. 2015;3:306–7.CrossRefPubMed
19.
go back to reference Tricco A, Lillie E, Zarin W, O’Brien K, Colquhoun H, Levac D et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med 2018;467-473. Tricco A, Lillie E, Zarin W, O’Brien K, Colquhoun H, Levac D et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med 2018;467-473.
23.
go back to reference Porter M, Teisberg E. Redefining Health Care: Value-Based Competition on Results Harvard Business School. Press Boston, MA. 2016. Porter M, Teisberg E. Redefining Health Care: Value-Based Competition on Results Harvard Business School. Press Boston, MA. 2016.
27.
go back to reference Harries AD, Kumar AMV, Satyanarayana S, Lin Y, Zachariah R, Lönnroth K, et al. Addressing diabetes mellitus as part of the strategy for ending TB. Trans R Soc Trop Med Hyg. 2015;110:173–9.CrossRef Harries AD, Kumar AMV, Satyanarayana S, Lin Y, Zachariah R, Lönnroth K, et al. Addressing diabetes mellitus as part of the strategy for ending TB. Trans R Soc Trop Med Hyg. 2015;110:173–9.CrossRef
33.
go back to reference Achanta S, Tekumalla RR, Jaju J, Purad C, Chepuri R, Samyukta R, et al. Screening tuberculosis patients for diabetes in a tribal area in South India. Public Health Action. 2013;3:43–7.CrossRef Achanta S, Tekumalla RR, Jaju J, Purad C, Chepuri R, Samyukta R, et al. Screening tuberculosis patients for diabetes in a tribal area in South India. Public Health Action. 2013;3:43–7.CrossRef
34.
go back to reference Dave P, Shah A, Chauhan M, Kumar AM v., Harries AD, Malhotra S et al. Screening patients with tuberculosis for diabetes mellitus in Gujarat, India. Public Health Action 2013;3: 29-33. Dave P, Shah A, Chauhan M, Kumar AM v., Harries AD, Malhotra S et al. Screening patients with tuberculosis for diabetes mellitus in Gujarat, India. Public Health Action 2013;3: 29-33.
35.
go back to reference Prakash BC, Ravish KS, Prabhakar B, Ranganath TS, Naik B, Satyanarayana S, et al. Tuberculosis-diabetes mellitus bidirectional screening at a tertiary care centre South India. Public Health Action. 2013;3:18–22.CrossRef Prakash BC, Ravish KS, Prabhakar B, Ranganath TS, Naik B, Satyanarayana S, et al. Tuberculosis-diabetes mellitus bidirectional screening at a tertiary care centre South India. Public Health Action. 2013;3:18–22.CrossRef
36.
go back to reference Mtwangambate G, Kalluvya SE, Kidenya BR, Kabangila R, Downs JA, Smart LR, et al. “Cough-triggered” tuberculosis screening among adults with diabetes in Tanzania. Diabet Med. 2014;31:600–5.CrossRefPubMed Mtwangambate G, Kalluvya SE, Kidenya BR, Kabangila R, Downs JA, Smart LR, et al. “Cough-triggered” tuberculosis screening among adults with diabetes in Tanzania. Diabet Med. 2014;31:600–5.CrossRefPubMed
37.
go back to reference Workneh MH, Bjune GA, Yimer SA. Assessment of health system challenges and opportunities for possible integration of diabetes mellitus and tuberculosis services in South-Eastern Amhara Region, Ethiopia: A qualitative study. BMC Health Serv Res 2016; 16 https://doi.org/10.1186/s12913-016-1378-6. Workneh MH, Bjune GA, Yimer SA. Assessment of health system challenges and opportunities for possible integration of diabetes mellitus and tuberculosis services in South-Eastern Amhara Region, Ethiopia: A qualitative study. BMC Health Serv Res 2016; 16 https://​doi.​org/​10.​1186/​s12913-016-1378-6.
39.
go back to reference Trinidad RM, Brostrom R, Morello MI, Montgomery D, Thein CC, Gajitos ML, et al. Tuberculosis screening at a diabetes clinic in the Republic of the Marshall Islands. J Clin Tuberc Other Mycobact Dis. 2016;5:4–7.CrossRefPubMedPubMedCentral Trinidad RM, Brostrom R, Morello MI, Montgomery D, Thein CC, Gajitos ML, et al. Tuberculosis screening at a diabetes clinic in the Republic of the Marshall Islands. J Clin Tuberc Other Mycobact Dis. 2016;5:4–7.CrossRefPubMedPubMedCentral
40.
go back to reference Fwoloshi S, Hachaambwa LM, Chiyeñu KO, Chirwa L, Hoffman TW, Ngalamika O et al. Screening for Diabetes Mellitus among Tuberculosis Patients: Findings from a Study at a Tertiary Hospital in Lusaka, Zambia. Can J Infect Dis Med Microbiol. 2018;2018. https://doi.org/10.1155/2018/3524926. Fwoloshi S, Hachaambwa LM, Chiyeñu KO, Chirwa L, Hoffman TW, Ngalamika O et al. Screening for Diabetes Mellitus among Tuberculosis Patients: Findings from a Study at a Tertiary Hospital in Lusaka, Zambia. Can J Infect Dis Med Microbiol. 2018;2018. https://​doi.​org/​10.​1155/​2018/​3524926.
41.
go back to reference Ncube RT, Dube SA, Machekera SM, Timire C, Zishiri C, Charambira K, et al. Feasibility and yield of screening for diabetes mellitus among tuberculosis patients in Harare Zimbabwe. Public Health Action. 2019;9:72–7.CrossRefPubMedPubMedCentral Ncube RT, Dube SA, Machekera SM, Timire C, Zishiri C, Charambira K, et al. Feasibility and yield of screening for diabetes mellitus among tuberculosis patients in Harare Zimbabwe. Public Health Action. 2019;9:72–7.CrossRefPubMedPubMedCentral
43.
go back to reference Basir MS, Habib SS, Zaidi SMA, Khowaja S, Hussain H, Ferrand RA et al. Operationalization of bi-directional screening for tuberculosis and diabetes in private sector healthcare clinics in Karachi, Pakistan. BMC Health Serv Res 2019;19. https://doi.org/10.1186/s12913-019-3975-7. Basir MS, Habib SS, Zaidi SMA, Khowaja S, Hussain H, Ferrand RA et al. Operationalization of bi-directional screening for tuberculosis and diabetes in private sector healthcare clinics in Karachi, Pakistan. BMC Health Serv Res 2019;19. https://​doi.​org/​10.​1186/​s12913-019-3975-7.
44.
go back to reference Majumdar A, Wilkinson E, Rinu PK, Maung TM, Bachani D, Punia JS, et al. Tuberculosis-diabetes screening: how well are we doing? A mixed-methods study from North India. Public Health Action. 2019;9:3–10.CrossRefPubMedPubMedCentral Majumdar A, Wilkinson E, Rinu PK, Maung TM, Bachani D, Punia JS, et al. Tuberculosis-diabetes screening: how well are we doing? A mixed-methods study from North India. Public Health Action. 2019;9:3–10.CrossRefPubMedPubMedCentral
45.
46.
go back to reference Ekeke N, Aniwada E, Chukwu J, Nwafor C, Meka A, Alphonsus C, et al. Screening diabetes mellitus patients for tuberculosis in southern nigeria: A pilot study. Adv Respir Med. 2020;88:6–12.CrossRefPubMed Ekeke N, Aniwada E, Chukwu J, Nwafor C, Meka A, Alphonsus C, et al. Screening diabetes mellitus patients for tuberculosis in southern nigeria: A pilot study. Adv Respir Med. 2020;88:6–12.CrossRefPubMed
47.
go back to reference Paul KK, Alkabab YMA, Rahman MM, Ahmed S, Amin MJ, Hossain MD, et al. A public-private model to scale up diabetes mellitus screening among people accessing tuberculosis diagnostics in Dhaka Bangladesh. Int J Infect Dis. 2020;92:56–61.CrossRefPubMedPubMedCentral Paul KK, Alkabab YMA, Rahman MM, Ahmed S, Amin MJ, Hossain MD, et al. A public-private model to scale up diabetes mellitus screening among people accessing tuberculosis diagnostics in Dhaka Bangladesh. Int J Infect Dis. 2020;92:56–61.CrossRefPubMedPubMedCentral
50.
go back to reference Nyirenda JLZ, Wagner D, Ngwira B, Lange B. Bidirectional screening and treatment outcomes of diabetes mellitus (DM) and Tuberculosis (TB) patients in hospitals with measures to integrate care of DM and TB and those without integration measures in Malawi. BMC Infect Dis 2022; 22 https://doi.org/10.1186/s12879-021-07017-3. Nyirenda JLZ, Wagner D, Ngwira B, Lange B. Bidirectional screening and treatment outcomes of diabetes mellitus (DM) and Tuberculosis (TB) patients in hospitals with measures to integrate care of DM and TB and those without integration measures in Malawi. BMC Infect Dis 2022; 22 https://​doi.​org/​10.​1186/​s12879-021-07017-3.
51.
52.
go back to reference Harries AD, Kumar AMV, Satyanarayana S, Lin Y, Zachariah R, Lönnroth K, et al. Diabetes mellitus and tuberculosis: Programmatic management issues. Int J Tuberc Lung Dis. 2015;19:879–86.CrossRefPubMedPubMedCentral Harries AD, Kumar AMV, Satyanarayana S, Lin Y, Zachariah R, Lönnroth K, et al. Diabetes mellitus and tuberculosis: Programmatic management issues. Int J Tuberc Lung Dis. 2015;19:879–86.CrossRefPubMedPubMedCentral
53.
go back to reference Naik B, Kumar AM v., Satyanarayana S, Suryakant MD, Swamy NM v., Nair S et al. Is screening for diabetes among tuberculosis patients feasible at the field level? Public Health Action 2013;3:34-37. Naik B, Kumar AM v., Satyanarayana S, Suryakant MD, Swamy NM v., Nair S et al. Is screening for diabetes among tuberculosis patients feasible at the field level? Public Health Action 2013;3:34-37.
54.
go back to reference Pizzol D, di Gennaro F, Chhaganlal KD, Fabrizio C, Monno L, Putoto G, et al. Prevalence of diabetes mellitus in newly diagnosed pulmonary tuberculosis in Beira Mozambique. Afr Health Sci. 2017;17:773–9.CrossRefPubMedPubMedCentral Pizzol D, di Gennaro F, Chhaganlal KD, Fabrizio C, Monno L, Putoto G, et al. Prevalence of diabetes mellitus in newly diagnosed pulmonary tuberculosis in Beira Mozambique. Afr Health Sci. 2017;17:773–9.CrossRefPubMedPubMedCentral
55.
59.
go back to reference Kapur A, Harries A. The double burden of diabetes and tuberculosis - public health implications Diabetes Res Clin Pract 2013;9-10. Kapur A, Harries A. The double burden of diabetes and tuberculosis - public health implications Diabetes Res Clin Pract 2013;9-10.
Metadata
Title
The collaborative framework for the management of tuberculosis and type 2 diabetes syndemic in low- and middle-income countries: a rapid review
Authors
Denise Michela Milice
Ivalda Macicame
José L.Peñalvo
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-024-18256-9

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