54 Chapter 3 Objectives This research aims to describe the epidemiology, predictive factors, and control measures of diabetes in a prospective cohort of patients who will be treated for TB. The objectives are to: 1. Describe the epidemiology of diabetes-TB comorbidity in a prospective cohort of patients receiving TB treatment in Eswatini from 1 June 2022 to 30 April 2023. 2. Identify factors that predict the occurrence of diabetes (or hyperglycaemia) in patients receiving TB treatment in Eswatini from 1 June 2022 to 30 April 2023. 3. Describe the effect of blood glucose on TB treatment outcome in patients receiving treatment for TB in Eswatini from 1 June 2022 to 30 April 2023, and ascertain if diabetes is a precursor of first-line TB drug resistance. 4. Ascertain if there is a relationship between baseline BMI, HIV status, blood glucose level and TB treatment outcomes in patients treated for TB in Eswatini. 5. Identify factors that hinder effective DM care amongst diabetics receiving TB treatment in Eswatini and propose a context-specific approach to address these factors. Methodology Study Design A mixed-methods prospective study design will be used for this study. For the quantitative part, a prospective cohort approach will be used to review data of consecutive newly diagnosed TB patients enrolled on care and followed up from June 1, 2022, to February 28, 2023. The qualitative part will involve the interview of select clinical healthcare workers who provide direct care to TB patients. Data from the prospective cohort will address objectives 1, 2, 3 and 4 while the healthcare worker's interview will address objective 5. Setting The study will be conducted at 12 health facilities providing TB services in the four regions of Eswatini (Mbabane Government Hospital, The Luke Commission, Phocweni Clinic, TB Center, Siphofaneni clinic, Mankayane Hospital, AHF Lamvelase Clinic, Raleigh Fitkin Memorial Hospital, AHF Matsapha, Pigg’s Peak Government Hospital, Nhlangano Health Center, Hlathikulu Hospital TB Clinic). The health facilities are purposively selected because they see more TB patients at any given time and have medical officers who review TB patients with standard laboratories and x-ray facilities to aid patient investigations. Only complicated cases are referred to the National TB Referral Hospital. The National TB Referral Hospital is excluded from this study as it was converted into a COVID-19 isolation
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