50 Chapter 3 In Eswatini, literature on DM in the population and DM – TB comorbidity is scarce with easily accessible data being estimates by WHO and International Diabetes Federation (IDF) (25). Available studies have centred on HIV–NCD comorbidity and developing effective integration models to address the increasing cases of NCDs among HIV patients (26). A 2020 study on the prevalence of abnormal blood glucose metabolism in adults indicated a 3.9% prevalence of type 2 DM in adults who attended the outpatient department of a tertiary hospital but no data is available on associated co-morbidities with TB or HIV(25). Similarly, the International Diabetes Federation estimates the prevalence of DM in Eswatini is 3.6% in people aged 20-79 years while the age-adjusted prevalence for impaired glucose tolerance is 6.9% (27). Significant progress has been made in the Kingdom of Eswatini in the provision of HIV/ TB services with HIV incidence in people 15 years and above reducing from 2.5% in 2011 to 1.4% in 2017 (28). Similarly, TB incidence reduced from 1069/ 100, 000 in 2009 to 363/100, 000 in 2019 (6). Despite these achievements in HIV/TB control, more is required to improve the quality of life of her citizens as more present with NCDs, notably cardiovascular diseases, DM and cancers (29). Data from the Eswatini Ministry of Health indicate DM accounted for 12% of outpatient department visits in 2018 and 5.9% of all in-patient mortality (29). Given the burden of TB in Eswatini, an increase in cases of DM due to lifestyle changes, obesity, and ageing may limit further successes in TB prevention activities. Further complicating the dilemma is the absence of reliable data on the prevalence of the common NCDs in the general population and diverse population groups, with the most recent reliable data on the burden of NCDs in Eswatini being the STEPS Survey, conducted in 2014 (30). Therefore, research on DM in people receiving treatment for TB will provide insight into the different factors that may impact DM and TB treatment outcomes and provide direction for effective health services delivery. This will help Eswatini achieve WHO’s target of reducing by a third, the burden of NCDs by 2025 (9). In this research, reference to diabetes means type 2 diabetes mellitus (T2DM).
RkJQdWJsaXNoZXIy MTk4NDMw