Improving diabetes and hypertension diagnosis in TB patients, Angola

Objectives

Angola has a high prevalence of tuberculosis 474 cases of tuberculosis per 100 000. Whereas the prevalence of diabetes in 2013 is 2,2% according to International Diabetes Federation. Moreover Angola is a country with rapid urbanisation, and derived changes in diet and lifestyle which is a huge risk for a higher development of diabetes cases.
There is a great need for improving diabetes and hypertension detection in TB patients as diabetes can worsen the clinical course of TB and TB can worsen glycaemic control in people with diabetes.

The goal of the project is to improve diabetes and hypertension detection and treatment in TB patients through the implementation of a pilot model on diabetes and tuberculosis within existing national TB programme structures

Approach

The project consists of five steps to improve diabetes and hypertension detection in TB patients.

First step is to establish mechanisms for a collaboration between diabetes and TB national programs. This includes quarterly coordination meetings and working groups with diabetes and TB national programs.

Second step is improvement of diabetes and hypertension detection in TB suspected cases through training and capacity building in selected centres in Luanda.

Third step is to improve the management of diabetes in patients with TB. Services will be activated to ensure proper referral and follow-up within the Angolan national healthcare system. Additionally awareness and capacity building.

Fourth step is to collect epidemiological data of diabetes prevalence among TB patients in Luanda. A mechanism of follow up of patients with diabetes tested in centres will be developed by the national working group. Monitoring and evaluation will be ensured to assessment adherence and treatment of TB treatment and quality of diabetes care.

Last step is to assemble national institutions, professional bodies, UN, patient groups and cooperation agencies to present the result of the project and the best way to integrate services in the Angola setting.

Results at completion

- Six TB DOT centres in Luanda provided capacity building and training, with a total of 50 health care professionals trained
- 7,205 TB patients screened for diabetes and hypertension at the six centres, with a total 431 detected with diabetes respectively 1,352 with hypertension
- National TB Programme guideline for integration of diabetes/hypertension screening into TB clinics developed and endorsed
- Data collection and analysis process completed; Scientific paper expected to be published (tbc)