Feasibility and yield of screening for non-communicable diseases among treated tuberculosis patients in Peru

Int J Tuberc Lung Dis. 2018 Jan 1;22(1):86-92. doi: 10.5588/ijtld.17.0381.

Abstract

Introduction: The increasing prevalence of non-communicable diseases (NCDs) poses a major challenge to low- and middle-income countries. Patients' engagement with health services for anti-tuberculosis treatment provides an opportunity for screening for NCDs and for linkage to care.

Methods: We explored the feasibility and yield of screening for NCDs in patients treated for tuberculosis (TB) in Lima, Peru, as part of a study focused on chronic respiratory sequelae. A representative sample of community controls was recruited from the same geographical area. Screening entailed taking a medical history and performing ambulatory blood pressure measurement and urinalysis.

Results: A total of 177 participants with previous TB (33 with multidrug-resistant TB) and 161 community controls were evaluated. There was an almost four-fold increased prevalence of self-reported diabetes mellitus (DM) in the TB group (adjusted prevalence ratio 3.66, 95%CI 1.68-8.01). Among those without self-reported DM, 3.3% had glycosuria, with a number needed to screen (NNS) of 31. The NNS to find one (new) case of hypertension or proteinuria in the TB group was respectively 24 and 5.

Conclusion: Patient-centred care that includes pragmatic NCD screening is feasible in TB patients, and the treatment period provides a good opportunity to link patients to ongoing care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure Monitoring, Ambulatory / methods
  • Cohort Studies
  • Diabetes Mellitus / diagnosis
  • Diabetes Mellitus / epidemiology*
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Mass Screening / methods*
  • Middle Aged
  • Noncommunicable Diseases / epidemiology*
  • Patient-Centered Care / methods
  • Peru / epidemiology
  • Prevalence
  • Tuberculosis / epidemiology*
  • Tuberculosis, Multidrug-Resistant / epidemiology
  • Urinalysis / methods
  • Young Adult