Service availability and readiness of tuberculosis units' clinics to manage diabetes mellitus in Lubumbashi, Democratic Republic of the Congo

BMC Health Serv Res. 2025 Feb 11;25(1):233. doi: 10.1186/s12913-025-12368-7.

Abstract

Introduction: In low-income countries such as the Democratic Republic of the Congo (DRC), the strategies implemented to combat tuberculosis (TB) are threatened by the emergence of non-communicable diseases (NCDs), such as diabetes mellitus (DM). Very little data on the implementation of services to manage TB-DM are generally available in these low-income countries. The aim of this study was therefore to assess the level of implementation of DM screening and treatment activities in TB unit clinics (TUCs) in Lubumbashi, DRC.

Methods: A cross-sectional study was conducted using the Service Availability and Readiness Assessment (SARA) questionnaire from June to July 2023. Fourteen tracer items, divided into 4 domains-i) guidelines and staff, ii) basic equipment, iii) diagnostic capacity, and iv) drugs and products-were assessed. The readiness indices were compared according to the managerial instance and the activity package organized in each of the selected TUCs. A Chi2 test with a significance level set at p = 0.05 was used for this comparison, and Cronbach's α coefficient was calculated to estimate the reliability or consistency of the questionnaire.

Results: Of the 35 TUCs visited, 19 (54.3%) were public health facilities, and 20 (57.1%) had a supplementary package of activities (SPA). The readiness of TUCs for providing DM diagnostic and treatment services was around 50%. A statistically significant difference was observed based on the managerial instance overseeing the TUC (p = 0.00) and the package of activities offered within these institutions (p = 0.00).

Conclusion: The current study has underscored the limited capability of TUCs in Lubumbashi to provide services for managing TB-DM comorbidity in DRC. It is imperative to implement strategies aimed at enhancing this capacity and taking into account the local context and influencing factors.

Keywords: Availability of services; Lubumbashi; Readiness; TB-DM comorbidity; TUCs.

MeSH terms

  • Ambulatory Care Facilities* / organization & administration
  • Cross-Sectional Studies
  • Democratic Republic of the Congo
  • Diabetes Mellitus* / diagnosis
  • Diabetes Mellitus* / therapy
  • Health Services Accessibility* / statistics & numerical data
  • Humans
  • Mass Screening
  • Surveys and Questionnaires
  • Tuberculosis* / therapy