Evaluation of point-of-care algorithms to detect diabetes during screening for latent TB infection

Details

• Alternative Title:
  Int J Tuberc Lung Dis
• Personal Author:
  Largen, A. ; Ayala, A. ; Khurana, R. ; Katz, D. J. ; Venkatappa, T. K. ; Brostrom, R.
• Description:
  BACKGROUND:
  
  Individuals with both diabetes mellitus (DM) and TB infection are at higher risk of progressing to TB disease.
  
  OBJECTIVE:
  
  To determine DM prevalence in populations at high risk for latent TB infection (LTBI) and to identify the most accurate point-of-care (POC) method for DM screening.
  
  METHODS:
  
  Adults aged ≥25 years were recruited at health department clinics in Hawaii and Arizona, USA, and screened for LTBI and DM. Screening methods for DM included self-report, random blood glucose (RBG), and POC hemoglobin A1c (HbA1c). Using HbA1c ≥6.5% or self-reported history as the gold standard for DM, we compared test strategies to determine the most accurate method while keeping test costs low.
  
  RESULTS:
  
  Of 472 participants, 13% had DM and half were unaware of their diagnosis. Limiting HbA1c testing to ages ≥30 years with a RBG level of 120–180 mg/dL helped identify most participants with DM (sensitivity 85%, specificity 99%) at an average test cost of US$2.56 per person compared to US$9.56 per person using HbA1c for all patients.
  
  CONCLUSION:
  
  Self-report was insufficient to determine DM status because many participants were previously undiagnosed. Using a combination of POC RBG and HbA1c provided an inexpensive option to assess DM status in persons at high risk for LTBI.
  
  
• Subjects:
  Adult Algorithms Blood Glucose Diabetes Mellitus Diabetes Mellitus, Type 2 Glycated Hemoglobin Humans Latent Tuberculosis Mass Screening Point-of-Care Systems
• Keywords:
  Arizona Hawaii Hemoglobin A1c Random Blood Glucose TBESC
• Source:
  Int J Tuberc Lung Dis. 25(7):547-553
• Pubmed ID:
  34183099
• Pubmed Central ID:
  PMC8609420
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Place as Subject:
  Arizona ; Hawaii
• Volume:
  25
• Issue:
  7
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:f9b2635075e90b50b9ebda0512f59a63e1830c4c2f1d1c63450acbb290741b5b
• Download URL:
  https://stacks.cdc.gov/view/cdc/111928/cdc_111928_DS1.pdf
• File Type:
  [PDF - 270.60 KB ]