The yield and feasibility of integrated screening for TB, diabetes and HIV in four public hospitals in Ethiopia.
Our objective was to demonstrate the feasibility of integrated care for TB, HIV and diabetes mellitus (DM) in a pilot project in Ethiopia.



Healthcare workers in four hospitals screened patients with TB for HIV and DM; patients with HIV for DM and TB; and patients with DM for TB. Fasting and random plasma glucose (RPG) tests were used to confirm the diagnosis of DM. We used screening checklists for TB and DM, and additional risk scoring criteria to identify patients at risk of DM.



Of 3439 study participants, 888 were patients with DM, 439 patients with TB and 2112 from HIV clinics. Six of the patients with DM had TB of whom five were already on treatment; and 141 (32.4%) patients with TB had DM, of whom only five were previously diagnosed with DM. Symptomatic patients and those with a risk score of 5 or more were about three times more likely to have abnormal blood glucose level. Of 2075 HIV patients with RPG determined, only 31 (1.5%) had abnormal RPG.



Tri-directional screening was feasible for detecting and managing previously undiagnosed TB and DM. More work is needed to better understand the interaction between HIV and DM.
Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL-TB) Project, Addis Ababa, Ethiopia.
Degu
D
Jerene
Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL-TB) Project, Addis Ababa, Ethiopia.
Nebiyu
N
Hiruy
Oromia Regional Health Bureau, Addis Ababa, Ethiopia.
Ilili
I
Jemal
Amhara Regional Health Bureau, Bahir Dar, Ethiopia.
Wondimu
W
Gebrekiros
Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL-TB) Project, Addis Ababa, Ethiopia.
Tadesse
T
Anteneh
Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL-TB) Project, Addis Ababa, Ethiopia.
Dereje
D
Habte
Management Sciences for Health, Help Ethiopia Address the Low Performance of Tuberculosis (HEAL-TB) Project, Addis Ababa, Ethiopia.
Muluken
M
Melese
Management Sciences for Health, Health Programs Group, Arlington, VA, USA.
Pedro
P
Suarez
Management Sciences for Health, Health Programs Group, Arlington, VA, USA.
Gloria
G
Sangiwa
D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D048909:Diabetes Complications / Q000175:diagnosis*; D003920:Diabetes Mellitus / Q000175:diagnosis*; D005002:Ethiopia; D005240:Feasibility Studies; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis*; D006779:Hospitals, Public; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010865:Pilot Projects; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis*
D001786:Blood Glucose
Diabetes mellitus; Ethiopia; HIV; Integrated; Non-communicable diseases; Tuberculosis