Screening coverage and treatment loss to follow-up of Diabetes and Tuberculosis (TB) patients in hospitals with measures to integrate care of Diabetes and TB and those without integration measures in Malawi

<b>Introduction:</b> There are efforts in Low and Middle-Income Countries to integrate care of Diabetes (DM) and Tuberculosis(TB) patients. Evidence on the effect of integration measures on actual screening coverage and patients outcomes is scarce. <b>Method:</b> Retrospective data of patients aged ≥15 were collected in 8 hospitals in Malawi (2016-2019). To assess bidirectional screening coverage we extracted symptom screening or microbiological testing for TB in DM patients and fasting blood glucose (FBG) for DM in TB Patients. For treatment loss to follow-up, in DM FBG at 6 months was assessed, and the WHO definition was used in TB. <b>Results:</b> 557 DM patients and 987 TB patients were assessed (mean age 54 and 40 respectively). Only 1 hospital had begun to integrate TB and DM care and 11% of both DM and TB patients were seen at this hospital. 47% of DM patients were hypertensive and 7% had HIV, while 54% of TB had HIV. TB screening was performed in &lt;1% of DM patients in non-integrating sites compared to 56% in an integrating hospital Risk Difference (RD) 55%, 95%CI 43, 68). DM screening was carried out in 5% of TB patients in non-integrated care and in 10% in integrated care (RD 5%, 95%CI 0,10). In non-integration, 8% of TB patients were lost to follow-up; while in integrated care none were lost to care were lost to follow-up after 6 months in care (RD -17%, 95%CI -29%, -4%). <b>Conclusion:</b> We found evidence of an increase in TB screening for DM patients with TB/DM integration measures, but only limited evidence on the increase of DM screening for TB patients and or decreases in treatment loss to follow up.