3. Reduce the burden of TB among people living with diabetes.

Screening and early diagnosis of TB among people who are at higher risk of developing TB is an important strategy for early identification of TB, for reducing morbidity and mortality due to TB and for preventing TB transmission. Systematic reviews have found that people living with diabetes are at higher risk of developing TB than people without diabetes, although people with glycaemic control are at lower risk than those with uncontrolled diabetes (2,94,95). One systematic review reported a median global prevalence of TB among people living with diabetes of about 4.1% (interquartile range: 1.8–6.2%) (96). Screening of people receiving care for diabetes for TB, particularly in high-TB burden settings, is therefore an opportunity to detect TB early and thus close the TB diagnostic gap. Close collaboration between TB and NCD programmes is essential to minimize loss to follow-up during the TB screening and diagnostic cascade and to ensure appropriate treatment of TB disease. In addition, close coordination between health providers is required to ensure that household members and close contacts are followed up for TB screening, as well as TB treatment and prevention if necessary.

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