Operational Handbooks

2.3.1 Identify priority comorbidities and interventions.

2.2.1 Assess the joint burden of TB and diabetes.

2.1.1 Strengthen political commitment, coordination and accountability for collaborative action on TB and diabetes.

To support countries in introducing and scaling up collaborative action on TB and comorbidities, including diabetes, WHO has developed the Framework for collaborative action on TB and comorbidities (referred to hereinafter as “the Framework”) (35). The Framework covers five areas that are central to delivering people-centred care for TB and comorbidities: (A) Strengthen governance and accountability for collaborative action; (B) Conduct an analysis of access to quality services for TB and comorbidities; (C) Coordinate planning and resource mobilization for collaborative ac

Box 1 summarizes the current WHO recommendations regarding interventions to address TB and diabetes. Other recommendations for TB screening, diagnosis, treatment and care, regardless of diabetes status, may also be applicable and have been published in respective modules of the WHO consolidated guidelines on TB, available on the WHO TB Knowledge Sharing Platform (https://tbksp.org/en) (24–32).
 

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.

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).

All references were accessed on 11 September 2024

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)