Young people in Pakistan carry an ethnicity – related high risk for obesity - driven type 2 diabetes. In recent years Pakistan has drastically increased of prevalence diabetes. As a high risk factor, obesity is raising rapidly specifically in urban areas. In 2010 World bank points out that Pakistan is facing health issues, due to the high increase of diabetes, obesity and heart disease. Poor families are highly targeted and the burden of poverty is getting worse.The purpose of this project is to develop a strategy for integrating diabetes and TB care in five districts of KP. It is proposed to train physicians and paramedics in Diabetes and TB clinics for systemic screening and provide material support.
There is a need to establish a project steering committee consisting of various local stakeholders within TB and diabetes to guide the development and implementation process.Through a model for Diabetes and TB integrated care, patients with diabetes and suspected for TB and TB patients suspected for Diabetes will be screened accordingly.In addition, a proposal for implementation of service is another key activity to reach objectives. Training and educating health care providers is crucial in order to create awareness at the clinics. Furthermore, these services need to be evaluated and monitored. Accordingly, regular visits and supervision should be carried out as well as, sharing monthly reviews and feedback among clinics and district health authorities.An important fact in this project is that the population of the five targeted districts is 8.5 million people; on a monthly basis an average 50 TB patients are treated at each TB clinic and 800 diabetes patients are treated at each diabetes clinic.
• 25 clinics strengthened to provide bidirectional screening (13 TB and 12 DM clinics)• 12,496 TB patients screened for diabetes (779 TB patients diagnosed with diabetes)• 67,213 diabetes patients screened for TB• 49 HCP trained in TB and diabetes management• 30 Awareness and mobilisation camps organised• 110 Monitoring visits conducted to address implementation issues• Results meeting held with key opinion leaders such as national TB control programme, diabetes society and WHO • Input re TB-DM bidirectional screening included in the National End TB Strategic Plan (2017-2020) for national scale up