Assessing the association between TB and diabetes in the Pacific

The association between diabetes mellitus and tuberculosis has been documented for many decades and for several years in the Pacific the association has been deemed as an important clinical and public health problem. There has been renewed interest about this association in recent years, particularly in Pacific Island countries and territories such as Federated States of Micronesia and Marshall Islands, who experience a dual burden of communicable and non communicable diseases. It is now accepted that diabetes mellitus is a significant risk factor for TB; with TB infection rates in diabetics two to ten times higher than in non diabetics. The effect of this association on clinical presentation, treatment response and drug resistance is still unclear; however it seems that TB and diabetes have a complex interaction which is amenable to further research.

 

Research studies on the association between the two diseases in the Pacific context have been lacking and in response, staff from the Secretariat of the Pacific Community (SPC) (TB and Health Pacific Lifestyle Sections), the Centers for Disease Control and Prevention (CDC) (Division of TB Elimination and Division of Diabetes Translation) and the Ministry of Health and Medical Services (Kiribati) developed a research protocol to assess the association between the two diseases. The research is titled: “Assessing the association between diabetes mellitus and tuberculosis in Kiribati.” The primary objective of the study is to determine the association between tuberculosis and diabetes mellitus in Kiribati with the secondary objective to characterize associations between diabetes mellitus and clinical aspects and treatment outcomes in patients with tuberculosis. The study design is a case control study with cases and controls enrolled from South Tarawa, Kiribati. The study itself will be completed in 24 months.

 

In early August, staff from SPC and CDC travelled to Kiribati to implement the study in conjunction with staff from the TB Control Centre- Ministry of Health and Medical Services. This involved meeting with stakeholders, training doctors and nurses directly involved in recruitment and data collection and field work to recruit community based controls. In the coming months a team of nurses will continue to interview and collect data from members of the community while TB Control Centre staff will test all TB patients for diabetes. Data collection will continue until August, 2011.

 

The results from the study will inform the Ministry of Health and Medical Services about the burden of diabetes in TB patients and the community in Kiribati. The study results will also further inform regional health agencies about the association between TB and diabetes in the Pacific context. This in turn may influence local and regional healthcare guidelines and policies, and will provide additional evidence for the draft standards for the management of TB and diabetes in the US affiliated islands. These standards may then be adopted by non US affiliated Pacific Island countries and territories with the aim of improving the care and management of patients with TB and diabetes.

Mise à jour le Mardi, 07 Septembre 2010 08:53
 

 

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