Glycemic control monitoring in patients with tuberculosis and diabetes: a descriptive study from programmatic setting in Tamil Nadu, India

Background: India’s national tuberculosis (TB) programme recommends that among patients with diabetes mellitus and TB, fasting blood glucose (FBG) be recorded at baseline, the end of intensive phase and the end of continuation phase of TB treatment. We conducted this operational research in select districts of Tamil Nadu, India, in 2016 to determine the availability of blood glucose records and glycemic control status during TB treatment.

Methods: This was a descriptive study involving secondary programme data. Glycemic control during TB treatment was ‘optimal’ if both baseline and end of intensive phase FBG (during TB treatment) were <130 mg/dl. In the absence of FBG, we used random blood glucose (RBG), with <180 mg/dl as the cut off.

Results: Of 438 patients, FBG at baseline, the end of intensive phase and the end of continuation phase were each available in <20%. Glycemic control status was known for 94% (412/438) patients at baseline and for 91% (400/438) during TB treatment. Among those with known glycemic status, glycemic control was not optimal in 77% of patients (316/412) at baseline and in 84% (337/400) during TB treatment. The proportion of patients with unfavourable TB treatment outcomes at the end of intensive phase was 11% (46/438) and at the end of continuation phase was 5% (21/438). We decided against assessing factors associated with glycemic control during TB treatment and association between glycemic control and TB treatment outcomes because glycemic control assessment, if any, was based mostly on RBG values.

Conclusion: Among patients with diabetes and tuberculosis, recording of FBG during tuberculosis treatment requires urgent attention.

Field evaluation of common poultry viral vaccinesin Egypt: a need for reassessment of the vaccine value chain

Egypt has a large traditional and exotic poultry sector which is challenged regularly by poultry diseases in endemic and epidemic proportions. The household poultry in particular is a source of livelihoods and employment for millions of low income citizens. Highly pathogenic avian influenza (HPAI) H5N1 and Newcastle disease are the most important poultry diseases in this sector. Whereas poultry vaccines are available to reduce the incidence of disease in Egypt, their effectiveness is doubtful. We conducted a biological evaluation of selected viral vaccines of poultry in three governorates in Egypt. Fifty‑four percent of the vaccines had reduced vaccine titres and the effect of secondary vaccine distributions was associated with the observed vaccine titres. External contamination was observed in some vaccines and break in cold chain was reported. Whereas no vaccine distributor used purpose‑built vaccine refrigerator, none also had prescribed protocol for vaccine handling or kept record of vaccine. There is a need to review vaccine handling procedure, monitor of vaccine cold chain more critically and review the whole chain that support vaccine distributions in Egypt.