Addressing the double-burden of diabetes and tuberculosis: lessons from Kyrgyzstan

Skordis‐Worrall, Jolene; Round, Jeff; Arnold, Matthias; Abdraimova, Aida; Akkazieva, Baktygul; Beran, David

doi:10.1186/s12992-017-0239-3

Cited by 13 publications

(19 citation statements)

References 20 publications

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“… 1 However, most low-income and middle-income countries (LMICs) still struggle with a high ID burden, due to the lack of financial resources of the often fragile healthcare systems. 2 3 Meanwhile, the adoption of Western nutritional and behavioural habits (eg, increased fast food consumption, alcohol intake and tobacco use) has caused a rapid increase in the burden of non-communicable diseases (NCD), such as diabetes, cancer and cardiovascular diseases (CVD). 4–7 In 2016, 31.5 million deaths in LMIC were caused by NCD, making up for over 75% of the global NCD mortality.…”

Section: Introductionmentioning

confidence: 99%

Gender inequality and the double burden of disease in low-income and middle-income countries: an ecological study

et al. 2021

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IntroductionMany low-income and middle-income countries (LMIC) suffer from a double burden of infectious diseases (ID) and non-communicable diseases (NCD). Previous research suggests that a high rate of gender inequality is associated with a higher ID and NCD burden in LMIC, but it is unknown whether gender inequality is also associated with a double burden of disease. In this ecological study, we explored the association between gender inequality and the double burden of disease in LMIC.MethodsFor 108 LMIC, we retrieved the Gender Inequality Index (GII, scale 0–1) and calculated the double burden of disease, based on disability-adjusted life-years for a selection of relevant ID and NCD, using WHO data. We performed logistic regression analysis to study the association between gender inequality and the double burden of disease for the total population, and stratified for men and women. We adjusted for income, political stability, type of labour, urbanisation, government health expenditure, health infrastructure and unemployment. Additionally, we conducted linear regression models for the ID and NCD separately.ResultsThe GII ranged from 0.13 to 0.83. A total of 37 LMIC had a double burden of disease. Overall, the adjusted OR for double burden of disease was 1.05 per 0.01 increase of GII (95% CI 0.99 to 1.10, p=0.10). For women, there was a borderline significant positive association between gender inequality and double burden of disease (OR 1.05, 95% CI 1.00 to 1.11, p=0.06), while there was no association in men (OR 0.99, 95% CI 0.95 to 1.04, p=0.75).ConclusionWe found patterns directing towards a positive association between gender inequality and double burden of disease, overall and in women. This finding suggests the need for more attention for structural factors underlying gender inequality to potentially reduce the double burden of disease.

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Section: Introductionmentioning

confidence: 99%

Gender inequality and the double burden of disease in low-income and middle-income countries: an ecological study

et al. 2021

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“…In the year 2015, there were 10.4 million incident TB cases worldwide [1]. However, through the “End TB Strategy,” the World Health Organization (WHO) set targets of 90 and 80% reduction in TB mortality and incidence, respectively, by 2030 [1, 2].…”

Section: Introductionmentioning

confidence: 99%

Availability and readiness of diabetes health facilities to manage tuberculosis in Tanzania: a path towards integrating tuberculosis-diabetes services in a high burden setting?

Shayo

2019

BMC Public Health

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Background The burden of tuberculosis (TB) and diabetes mellitus (DM) is rising and substantially affecting the low-income countries, including Tanzania. Integrated management of TB and DM is becoming of importance in TB high burden countries. In this study, we sought to assess the availability and readiness of diabetes facilities to manage TB in Tanzania. Methods The present study was based on a secondary analysis of the 2014–2015 Tanzania Service Provision Assessment Survey data. We calculated the service availability as a percentage of diabetes facilities offering TB services: diagnosis and treatment. Regarding the readiness of diabetes facilities to provide TB management, we calculated based on the three domains: staff training and guideline, diagnostics, and medicines as identified by World Health Organization-Service Availability and Readiness Assessment (SARA) manual. A score of at least half (≥50%) of the indicators listed in each of the three domains was considered as high readiness. We used a descriptive statistics to present our findings. Results There were 619 DM facilities all over the country of which only 238 (38.4%) had TB services.72.6 and 62.6% of these DM facilities with TB services were publicly owned and located in rural settings respectively. Generally, DM facilities had low readiness to manage TB; 12·6%. More specifically, all DM facilities had low readiness in terms of trained staff and guidelines. However, in the domain of diagnostics and medications, higher levels of care (hospitals) had a comparatively higher level of readiness to manage TB. Conclusion Most of the DM facilities had low availability and readiness to manage TB. The findings of our study display an urgent need to mobilize important resources to enhance the integration of TB services in DM facilities. This includes medications, management guidelines, diagnostics, and health professionals who have received refresher training on TB/DM co-management. However, presently, few DM facilities may be allowed to start managing TB as per the Strategic and Action Plan for the Prevention and Control of Non-Communicable Diseases in Tanzania 2016–2020.

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“… 29 37 Patients with TB-DM comorbidity did not appear to receive comparable treatment, and this may be due to more funding being available to TB, compared with diabetes and the limited number of staff trained in co-management. 37 114 …”

Section: Resultsmentioning

confidence: 99%

Implementation of the WHO’s collaborative framework for the management of tuberculosis and diabetes: a scoping review

2021

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ObjectiveTo map evidence on the implementation of the WHO’s collaborative framework for the management of tuberculosis (TB) and diabetes mellitus (DM) comorbidity, globally.DesignScoping review.MethodsGuided by Arksey and O’Malley’s scoping review framework, this review mapped literature on the global implementation of the framework for the management of TB and DM comorbidity, globally. An extensive literature search for peer-reviewed studies, theses, studies in the press and a list of references from the selected studies was conducted to source-eligible studies. PubMed, Google Scholar, Web of Science, Science Direct, the EBSCOhost platform (academic search complete, health source: nursing/academic edition, CINAHL with full text), Scopus and the WHO library were used to source the literature. We performed title screening of articles using keywords in the databases, after which two independent reviewers (RS and PV) screened abstracts and full articles. Studies from August 2011 to May 2021 were included in this review and the screening was guided by the inclusion and exclusion criteria. Findings were analysed using the thematic content analysis approach and results presented in the form of a narrative report. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension was used as a checklist and for explaining the scoping review process.ResultsThis review found evidence of the WHO TB-DM collaborative framework’s implementation in 35 countries across the globe. TB-DM comorbidity was identified in patients through bidirectional screening of both patients with TB and patients with DM in rural and urban settings.ConclusionDue to the paucity of evidence on mechanisms of collaboration, we recommend further research in other implementing countries to identify techniques used for diagnosis and integration of TB and DM services, in order to ensure that effective and joint management of TB-DM comorbidity in populations is achieved.

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Addressing the double-burden of diabetes and tuberculosis: lessons from Kyrgyzstan

Cited by 13 publications

References 20 publications

Gender inequality and the double burden of disease in low-income and middle-income countries: an ecological study

Gender inequality and the double burden of disease in low-income and middle-income countries: an ecological study

Availability and readiness of diabetes health facilities to manage tuberculosis in Tanzania: a path towards integrating tuberculosis-diabetes services in a high burden setting?

Implementation of the WHO’s collaborative framework for the management of tuberculosis and diabetes: a scoping review

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