The World Health Organization (WHO) has published an updated Operational handbook on tuberculosis and comorbidities. In addition to recommendations on the co-management of TB and mental health disorders, including those related to substance use, as well as TB and HIV, the third edition of the handbook provides guidance on comprehensive care for people with tuberculosis and diabetes.
According to the 2024 WHO Global TB Report, diabetes is one of the key determinants of TB, with about 400 000 TB episodes attributable to diabetes worldwide. This is likely to increase as the global burden of diabetes increases, including in low- and middle-income countries where there is a high prevalence of TB.
The updated operational handbook aims to facilitate comprehensive and people-centred care for people with TB and diabetes. It contains practical guidance to facilitate the implementation of WHO recommendations, as well as information on screening, prevention, diagnosis and co-management of both conditions. Implementation of the guidance is expected to increase access to diagnosis for people with TB and diabetes, improve the management and care of people with both conditions and improve health outcomes, including health related quality of life.
Currently, the WHO Operational handbook on tuberculosis and comorbidities consists of three parts: Mental health conditions and substance use disorders, HIV, and Diabetes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health.