Operational Handbooks

1.2 Development of the document

Development of the TB/DM section was coordinated by the WHO GTB in collaboration with the WHO Department of Noncommunicable Diseases, Rehabilitation and Disability. Systematic reviews were commissioned on considerations for implementation of existing WHO recommendations. In October 2023, WHO convened a stakeholder consultation with a wide range of experts and representation from all WHO regions to provide input to the guidance.

1.1 Background and burden of TB and diabetes

Tuberculosis (TB) remains a major cause of ill-health and disability in many low- and middle-income countries and is a leading cause of death due to an infectious agent globally (1). The risk of TB is elevated in people with diabetes mellitus (DM). In studies in which the type of diabetes was not specified, people with diabetes were found to have a 1.9 (95% confidence interval, 1.5 ; 2.4) times higher risk of developing TB than those without diabetes (2).

Definitions

Adolescent: a person aged 10–19 years (1) Adult: a person over 20 years of age (1)

Bacteriologically confirmed TB: a person from whom a biological specimen is positive by a WHOrecommended rapid diagnostic test, culture or smear microscopy (2) 

Child: a person under 10 years of age (1) 

Acknowledgements

This section of the WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities was developed by Annabel Baddeley (WHO Global Tuberculosis Programme [GTB]) with support from Bianca Hemmingsen (Department of Noncommunicable Diseases, Rehabilitation and Disability) and Julia Critchley (consultant) with input from Anna Carlqvist, Kerri Viney, Matteo Zignol and Farai Mavhunga, all at the WHO GTB, and Slim Slama (Department of Noncommunicable Diseases, Rehabilitation and Disability), under the overall direction of Tereza Kasaeva, Director, WHO GTB.