Development of risk score for tuberculosis detection among diabetic patient in Kelantan

2 district randomly selected in Kelantan, Malaysia for Intervention and control group Tuberculosis Diabetes Mellitus Predictive Tool (TBDM-PT) developed from the analysis of secondary data (Patient Medical record) and literature review to find the associated factor risk of TB among diabetic patient which subsequently undergone content and face validation. It may contain 4-5 simple question including sociodemograph, glycemic control and scoring point for each variable included base on Beta coefficient from significant factor from Multiple logistic regression and highest coverage of Area Under Curve (AUC) graph. From the AUC we can determine either the participant categorize as low or high risk. For Intervention group, Patient with history of DM for at least 6 month will be screened with the Tuberculosis Diabetic Mellitus Predictive Tool (TBDM-PT). Intervention use in this study using the Tuberculosis Diabetic Mellitus Predictive Tool (TBDM-PT) develop to triage risk of Tuberculosis (TB) either high risk or low risk among DM patient and subsequently proceed to standard available diagnostic testing including Chest X-Ray,Acid Fast Bacilli (AFB) sputum and Tuberculin skin test (TST). The risk score will be calculated by a trained staff using pre-existing information on medical records (after patient consent) and therefore will not directly involve any participant time. It only take about 10-15 minutes for each assessment using the pre-existing information. The triaging will be done by trained health care staff at selected government health clinic for a Diabetic Clinic walk-in patient. Based on the risk score, patient may be categorized either high risk or low risk. Once the score obtained, It will be provided to the nurse immediately after the consultation for diagnostic test appointment. The dedicated health care staff will arrange a TB diagnostic test as stated above for high risk patient and the data will be included in study analysis. Meanwhile the low risk will proceeded to current TB screening program and will be exclude from study analysis. To ensure the adherence to the intervention, verbal confirmation from patient is required and patient will be contacted by health staff after 1 month if not come for diagnostic test as scheduled.