Victor Williams

93 4 Diabetes-tuberculosis comorbidity in a low-income setting was 3.8% and 3.9%, respectively [21]. There is no documented data on the prevalence of DM in people receiving treatment for TB in Eswatini. This study, therefore, aims to describe the epidemiology of elevated blood glucose (DM and pre-DM) in a cohort of patients from Eswatini who received TB treatment (the majority of whom are living with HIV), the effect of blood glucose on TB treatment outcome and predictors of elevated blood glucose and unfavourable TB treatment outcomes in the cohort. Methods Study design, Context and Study setting This study used a prospective cohort design. The cohort comprised newly diagnosed patients enrolled on TB care from the 1st of June to the 30th of September 2022. A description of the context and approach to TB services provision in Eswatini and the study setting has been published previously [22]. In brief, the Ministry of Health's (MOH) National Tuberculosis Control Program coordinates TB services in Eswatini through community and health facility-based case-finding, referral, and linkage to treatment services. Different funding agencies, non-governmental organisations and civil society organisations also provide additional support for TB services provision. The study was conducted at 11 health facilities providing TB services in Eswatini (12 sites were selected, but one did not participate). Health facilities with the highest number of patients two quarters before the study commenced were selected from the four regions of Eswatini to maximise the number of participants that can be enrolled. Study participants, sample size and sampling The study participants, sample size and sampling approach have been described [22]. In summary, the study participants were new patients aged ≥18 years enrolled on TB care and followed until the end of treatment for patients receiving treatment for drugsensitive TB and the end of six months for patients receiving treatment for DRTB. From the study protocol [22], using an estimated DM prevalence of 3.6%, an effect size of 0.05, a 5% error rate and a power of 90%, a sample size of 380 – 430 (mean 405) participants were expected but 352 participants were eventually enrolled in the study as one health facility did not participate in the study. A consecutive sampling approach was used to include all consenting patients newly enrolled on TB care.

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