Feasibility and outcomes of diabetes mellitus screening in people with tuberculosis in Burundi

Background Diabetes mellitus (DM) is associated with an increased risk of death and relapse during tuberculosis (TB) treatment. Systematic screening and treating DM can improve outcomes. However, DM screening is poorly implemented in low-resource settings. We discuss implementation and results from the first integrated DM screening program in TB treatment centers in Burundi. Methods People diagnosed with TB who consented were screened for DM. The prevalence and number needed-to-test (NNT) for DM in people with TB with unknown DM status were estimated. Predictors for DM were assessed using multivariable logistic regression. Enablers for further rollout were documented. Results Among 324 people with TB (April-September 2023), 6.8% (95% CI 4.4 to 10.1%) had DM. A family history of DM, tobacco consumption and being unemployed predicted DM. The NNT to find a DM case was 15. Enablers for further national rollout of DM/TB screening include health promotion for people with TB, healthcare worker training, free-of-charge DM testing and integration of DM treatment at the point of TB treatment. Conclusion In Burundi, systematic DM screening in people with TB is relevant and feasible if remaining challenges are addressed. DM diagnosis, care and treatment should be provided free-of-charge in TB treatment centers.