Key research questions	Priority	Study design and methodology
Screening for Disease: Screening patients with DM for active TB Screening patients with TB for DM	High	Prospective observational cohort studies of DM patients routinely attending diabetes clinics and screened for TB, and TB patients starting anti-TB treatment and screened for DM
TB treatment outcomes in patients with DM and with non-diabetes hyperglycaemia, including a more detailed assessment of death during anti-TB treatment, and the development and testing of strategies to improve outcomes for both diseases	High	Prospective observational cohort studies using standardised TB regimens and standardised treatment outcomes and focusing on defined primary outcomes Prospective observational cohort studies to determine when death occurs in relation to start of TB treatment, the aetiology and whether case fatality is reduced by better control of DM or hyperglycaemia or modification to TB drug regimens, duration of therapy and TB drug doses
Implementing and evaluating the “DOTS” model for standardised case management of DM	High	Operational research that includes quarterly cohort reporting of new cases, treatment outcomes of cumulative cases including frequency of co-morbidities such as TB, and survival analysis
Development and evaluation of better point-of-care diagnostic and monitoring tests for DM	High	Developmental work to produce a reliable low cost finger stick test for measuring blood glucose and glycated haemoglobin A1c (HbA1c) in rural areas, which then needs to be tested for efficacy and feasibility in the field
Rates of hospitalisation and additional medical costs associated with diagnosis and management of dual disease	Medium	Cross-sectional and case-control studies
Use of the community to improve diagnosis, management and care of patients with diabetes and TB	Medium	Operational research
Household contact tracing of adult patients with smear- positive Pulmonary TB	Medium	Prospective observational studies to determine the yield of screening household contacts of index Pulmonary TB patients for TB infection, active TB, HIV and DM, and assess whether DM influences the risk of TB infection
Radiographic findings in DM patients with tuberculosis	Medium	Systematic review of the literature, and prospective cross-sectional studies if further evidence is required, to determine the common radiographic patterns that are associated with DM
Modelling the effect of the DM epidemic on the TB epidemic	Medium	Mathematical modelling studies, ideally informed by higher quality studies of the association between DM and TB, particularly from low-income settings
TB preventive therapy in patients with DM	Low	Randomised controlled trial assessing efficacy and safety of isoniazid preventive therapy in reducing risk of active TB in patients with DM

DM = diabetes mellitus; TB = tuberculosis; HIV = human immunodeficiency virus