Project Description

Author: Rafi et al.


Background: Comorbidity of diabetes mellitus (DM) in tuberculosis (TB) patients is a major public health concern in lower middle income countries including Bangladesh. An integrated approach is required for control and treatment of both DM and TB. The objective of the present study was to investigate the availability and readiness of Tuberculosis care centers in Bangladesh toward diabetic patients management.

Methods: The presents study was based on analysis of a secondary data obtained from the Bangladesh Health Facility Survey (BHFS) 2017. Data collected from a total of 303 facilities providing TB services were retrieved The outcome variables of the present study were availability and readiness of the TB health facilities for providing DM service. Readiness was measured for four domains: staff and guidelines, equipment, diagnostic facility and basic medicine. The independent variables were: facility level, management authority and location of the facility. Binary and multiple logistic regression models were constructed for both the outcome variables (availability and readiness) to find out their predictors.

Results: Almost 68.3% of the TB facilities were available to provide DM services while high readiness was reported by 36.3% of the facilities. For domain-specific readiness index, readiness was reported in 46%, 96%, 38% and 25% facilities in the staff and guidelines, equipment, diagnostic facility and basic medicine domain respectively. In the logistic regression model, availability of DM services was better in primary level (aOR 2.62, 95% CI 1.78-4.77) and secondary level (aOR 3.26, 95% CI 1.82-9.05) facilities compared to community facilities. Similarly, readiness of DM care was also better in these facilities (aOR 2.55, 95% CI 1.05-4.71 for primary and aOR 2.75, 95% CI 1.80-4.32 for secondary facilities). Besides private TB facilities had better availability (aOR 2.84, 95% CI 1.75-5.89) and readiness (aOR 2.52, 95% CI 1.32-4.29) for DM care.

Conclusions: Availability and readiness for providing DM services in TB care providing facilities in Bangladesh is inadequate. Both community level and primary care facilities providing TB care should be better equipped to provide integrated diabetes care.

Keywords: Tuberculosis; Diabetes mellitus; Availability; Readiness; Health facilities

Status: Ongoing

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