title: Screening for diabetes mellitus among tuberculosis patients in Southern Nigeria: a multi-centre implementation study under programme settings.
abstract: Implementation studies are recommended to assess the feasibility and effectiveness of programmes. In Nigeria, little is known about the burden of diabetes mellitus (DM) among tuberculosis (TB) patients. The objective of this study was to determine screening efficacy, prevalence of DM and determinants of DM among TB patients. We report on a multi-centre implementation study carried-out in 13 health facilities in six States of Southern Nigeria. All newly diagnosed TB patients registered from March to October 2015 were screened for DM using current World Health Organisation guidelines. Overall, 2094 TB patients were evaluated, 196 (9.4%) were found to have DM. The prevalence of newly diagnosed DM was 5.5% (115/2094). DM prevalence varied according to age group; occurring in 2.2% of patients aged ≤ 25 years and 16.9% in patients aged (56-65) years. The additional yield of DM was 59% while the number needed to screen to detect a new case of DM was 18. Factors associated with DM were; age >40 years (aOR2.8, CI 2.1-3.9), rural residence (aOR2.3, 1.6-3.2), private health facility care (aOR2.0, 1.4-2.7), and having an occupation that engages in vigorous activity (aOR0.6, 0.4-0.9). The burden of DM among TB patients is high. Prioritization of DM screening for TB patients is indicated.
authors.affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.
authors.forename: Ngozi
authors.initials: N
authors.lastname: Ekeke
authors.affiliation: Department of Medicine, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria.
authors.forename: Kingsley N
authors.initials: KN
authors.lastname: Ukwaja
authors.affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.
authors.forename: Joseph N
authors.initials: JN
authors.lastname: Chukwu
authors.affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Nwafor
authors.affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.
authors.forename: Anthony O
authors.initials: AO
authors.lastname: Meka
authors.affiliation: Department of Medicine, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.
authors.forename: Eruke E
authors.initials: EE
authors.lastname: Egbagbe
authors.affiliation: Ogun State Tuberculosis and Leprosy Control Programme, Ministry of Health, Abeokuta, Ogun State, Nigeria.
authors.forename: Festus O
authors.initials: FO
authors.lastname: Soyinka
authors.affiliation: Ebonyi State Tuberculosis and Leprosy Control Programme, Ministry of Health, Abakaliki, Ebonyi State, Nigeria.
authors.forename: Isaac
authors.initials: I
authors.lastname: Alobu
authors.affiliation: Enugu State Tuberculosis and Leprosy Control Programme, Ministry of Health, Enugu, Enugu State, Nigeria.
authors.forename: Ifeanyi
authors.initials: I
authors.lastname: Agujiobi
authors.affiliation: Ondo State Tuberculosis and Leprosy Control Programme, Ministry of Health, Akure, Ondo State, Nigeria.
authors.forename: Samuel
authors.initials: S
authors.lastname: Akingbesote
authors.affiliation: Edo State Tuberculosis and Leprosy Control Programme, Ministry of Health, Benin City, Edo State, Nigeria.
authors.forename: Osagie
authors.initials: O
authors.lastname: Igbinigie
authors.affiliation: Cross River State Tuberculosis and Leprosy Control Programme, Ministry of Health, Calabar, Cross River State, Nigeria.
authors.forename: Job B
authors.initials: JB
authors.lastname: Offor
authors.affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.
authors.forename: Nelson O
authors.initials: NO
authors.lastname: Madichie
authors.affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.
authors.forename: Chukwuka
authors.initials: C
authors.lastname: Alphonsus
authors.affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.
authors.forename: Moses C
authors.initials: MC
authors.lastname: Anyim
authors.affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.
authors.forename: Obinna K
authors.initials: OK
authors.lastname: Mbah
authors.affiliation: Medical Department, German Leprosy and TB Relief Association, Enugu, Enugu State, Nigeria.|Department of Community Health and Psychiatry, University of West Indies, Jamaica.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Oshi
mesh_terms: D000328:Adult; D000367:Age Factors; D048909:Diabetes Complications / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D015995:Prevalence; D014376:Tuberculosis / Q000453:epidemiology*