Tuberculosis in Yogyakarta

Tuberculosis remains a leading cause of mortality in Indonesia, particularly among individuals with chronic conditions like Diabetes Mellitus. This study was conducted at UGM Academic Hospital to understand the extent of TB co-infection among DM patients and assess whether active two-way screening could improve early detection. Using both a standardized symptom screening tool (PERJAKA 2M) and chest x-rays, researchers aimed to identify suspected TB cases systematically.

The descriptive cross-sectional design allowed the investigators to capture data over a six-week period among 109 consenting DM patients. The PERJAKA 2M instrument flagged about one in five patients as TB suspects based on symptoms alone. However, chest x-rays revealed radiologic signs of TB in only 3 patients, suggesting that symptom screening might overestimate suspicion rates without confirmatory imaging.

Sputum examinations, which serve as the definitive test, confirmed TB in only one individual. While this proportion appears low, it underscores the importance of maintaining vigilance in high-risk groups. Many DM patients with TB-like symptoms might have other pulmonary or metabolic complications mimicking TB presentations.

Despite limitations in scope and sample size, the findings highlight that active screening can detect cases potentially missed during routine care. The combination of symptom checklists, imaging, and sputum analysis ensures a more reliable diagnosis pathway, supporting national TB control efforts.

Future research should consider larger populations across multiple centers to strengthen the evidence base. Incorporating socioeconomic and nutritional variables may also clarify the risk profile of DM patients for TB infection. Overall, this study contributes valuable insights into operationalizing TB screening in a real-world clinical setting.

Source:

1. Hariyanto, S.W., Avidati, H., Ulfah, U., Nurlaily, A.N. and Tejaningrum, K.D., Tuberculosis Screening in Patients with Diabetes Mellitus at the Internal Medicine Clinic of UGM Academic Hospital: Descriptive Study. Academic Hospital Journal, 7(1), p.8.