Employer led model for TB and diabetes care in BEST, Mumbai, India

BEST is a public sector enterprise in Mumbai providing transportation and electric supply services. Its 30000 employees receive health services from its network of dispensaries. Regular preventive and curative services are offered according to guidelines. It also runs all public health programs including National TB Elimination Program. It is established that Diabetes increases risk of TB and negatively impacts treatment outcomes. To demonstrate Employer led model and intensified collaborative activities for TB and Diabetes care in BEST, Mumbai: The is a description study with cross sectional design. All Diabetic employees were given awareness talks of benefits of early diagnosis and treatment of TB along with the risks and benefits of tests. 1127 Diabetic employees volunteered after verbal consent for clinical evaluation and Xray and participated in the study. Of the 1127 diabetics screened for TB through clinical examination and Xray, abnormality was detected in 11 patients. The sputum sample of these patients was sent for NAAT of which 1 patient came positive. Another patient whose sample was negative, demonstrated active signs of TB on further clinical evaluation. 2 patients were put on treatment and both patients have favourable outcome.An integrated approach for TB-DM, implemented by the employer, where all DM patients were screened for TB has shown a significant impact on reduction in number of TB cases. BEST promotes organisations and advocates for policy to adopt their models and screen all diabetic patients for TB through clinical examination and X ray.