Why should India be concerned about TB and diabetes?
India is now facing a huge double burden of these two diseases. It has both-- the largest number of TB patients in the world and the second largest number of DM cases. Hence the associated link between TB and DM is a matter of growing concern for India. In 2014 there were 2.5 million prevalent TB cases (23% of the global cases), and 0.2 million TB deaths (excluding those with HIV also). In the same year there were 66.8 million Indians living with diabetes (17% of the world cases).
In a recent webinar hosted by CNS (Citizen News Service), Dr KS Sachdeva, Additional Deputy Director General (TB), Central TB Division, Ministry of Health and Family Welfare, Government of India, spoke about the need to intensify TB-DM collaborative activities in public healthcare programmes as several studies have indicated a 13% concordance of TB-DM (Webinar recording is online at: https://www.youtube.com/watch?v=M6fONxjPhv0 ).
He informed that the TB-DM Collaborative framework developed by India is already been implemented in 100 districts and will soon be expanded to 180 districts where NPCDCS programme is currently operational. The main objectives of this framework are:
- To establish mechanisms of collaboration between NPCDCS and RNTCP for addressing co-existing TB and DM comorbidity
- To improve screening and detection of active TB cases in patients registered at NCD clinic and manage appropriately
- To intensify early screening and diagnosis of DM in registered TB patients and manage appropriately
- To establish surveillance, monitoring and evaluation mechanism
The programme involves (i) screening of all registered TB patients for DM, to ensure DM management among TB patients; and (ii) intensified detection of active TB disease among DM patients, to ensure TB treatment and management in comorbid patients and also to ensure TB infection control measures in health care settings where DM is managed.
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