title: Screening of patients with diabetes mellitus for tuberculosis in community health settings in China.
abstract: OBJECTIVE
  To assess the feasibility and results of screening of patients with DM for TB in routine community health services in China.
  
  
  METHODS
  Agreement on how to screen patients with DM for TB and monitor and record the results was obtained at a stakeholders meeting. Subsequent training was carried out for staff at 10 community health centres, with activities implemented from June 2013 to April 2014. Patients with DM were screened for TB at each clinical visit using a symptom-based enquiry, and those positive to any symptom were referred to the TB clinic for TB investigation.
  
  
  RESULTS
  A total of 2942 patients with DM visited these ten clinics. All patients received at least one screening for TB. Two patients were identified as already known to have TB. In total, 278 (9.5% of those screened) who had positive TB symptoms were referred for TB investigations and 209 arrived at the TB centre or underwent a chest radiograph for TB investigation. One patient (0.5% of those investigated) was newly diagnosed with active TB and was started on anti-TB treatment. The TB case notification rate of those screened was 102/100,000.
  
  
  CONCLUSIONS
  This pilot project shows it is feasible to carry out TB screening among patients with DM in community settings, but further work is needed to better characterise patients with DM at higher risk of TB. This may require a more targeted approach focused on high-risk groups such as those with untreated DM or poorly controlled hyperglycaemia.
authors: International Union Against Tuberculosis and Lung Disease, Beijing, China.
authors: Yan
authors: Y
authors: Lin
authors: Family Health International, Bangkok, Thailand.
authors: Anh
authors: A
authors: Innes
authors: Tuberculosis Prevention Center, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China.
authors: Lin
authors: L
authors: Xu
authors: Family Health International, Kunming, China.
authors: Ling
authors: L
authors: Li
authors: Tuberculosis Prevention Center, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China.
authors: Jinou
authors: J
authors: Chen
authors: Tuberculosis Prevention Center, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China.
authors: Jinglong
authors: J
authors: Hou
authors: Beijing Chest Hospital, Capital Medical University, Beijing, China.|Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors: Fengling
authors: F
authors: Mi
authors: Beijing Chest Hospital, Capital Medical University, Beijing, China.|Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China.
authors: Wanli
authors: W
authors: Kang
authors: International Union Against Tuberculosis and Lung Diseases, Paris, France.|London School of Hygiene and Tropical Medicine, London, UK.
authors: Anthony D
authors: AD
authors: Harries
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D002681:China; D003153:Community Health Services; D003920:Diabetes Mellitus; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D015995:Prevalence; D011634:Public Health / Q000379:methods*; D012017:Referral and Consultation; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology
keywords: China; Chine; Tuberculosis; communauté; community; comunidad; cribado; diabetes mellitus; diabète sucré; dépistage; screening; tuberculose; tuberculosis