125 5 Diabetes – Tuberculosis Care in Eswatini Quality and current standards of care Treatment guidelines More than half of the participants (n=12) indicated Standard Operating Procedures (SOP) or documents to guide the care of TB patients with DM or other non-communicable diseases were not available. “The guidelines (TB and HIV) are clear and good for me, but we need a clear guideline on the NCDs aspect because for now, much attention is given to TB and ART forgetting about NCDs.” R3 “We do not have a proper protocol (for TB-DM). We just manage the patient based on what we are doing as our routine practice.” R22 Screening for DM The random blood glucose or fasting glucose test was commonly used by healthcare workers to screen and diagnose DM, and 14 respondents indicated they screen patients at baseline. “We check the fasting or random blood sugar using a glucometer depending on if the patient has eaten or not… If it was random blood sugar, I can ask the patient to come the following day not eaten so we can do a fasting blood sugar and further review” R10 HbA1c and Oral glucose tolerance test Participants were aware of the HbA1c and the oral glucose tolerance tests, but these were either not available or had a long turnaround time. Only 6 respondents stated they screened patients at baseline with HbA1c. “…In our facility, we do not perform the HbA1c test and again we do not do the oral glucose tolerance test” R1 “…the HbA1c test is available, but we do not have the reagents, so we are not doing it currently” R11 “The HbA1c test is not run here but in Mbabane, we are usually allocated a day wherein they come and collect the sample. So, if a patient comes on Monday, she has to wait for Friday so that the specimen can be collected” R14 Care of TB – DM patients The participants had different approaches to providing care for TB patients with DM. A common practice was to refer the patient to a hospital or a doctor if the facility was
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