One blood drop, two diseases: integrating diabetes screening into malaria services to advance primary health care in Côte d’Ivoire

Objective To propose a systematic integration of diabetes screening into malaria diagnostic protocols within primary health care as an effective strategy to strengthen early diabetes detection in malaria-endemic regions. Methods This commentary draws on preliminary qualitative evidence from research conducted in Abidjan, Côte d'Ivoire between March and May 2022 with patients living with type 2 diabetes and healthcare professionals. Results Preliminary data suggests malaria-endemic contexts may act as a barrier to diabetes testing. Some patients attributed their symptoms to malaria, delaying their diabetes diagnosis, while some healthcare professionals reported instances when they attributed symptoms to malaria without ordering glucose tests, leading to missed diabetes diagnoses. Other healthcare professionals noted that including blood glucose measurement in malaria investigations enabled the identification of previously undiagnosed diabetes, thus leading to opportunities for policy change to improve early diagnosis. Conclusions Integrating diabetes screening into malaria diagnostic protocols within primary health care offers a pragmatic and non-invasive opportunity for early screening. Leveraging global efforts to fight malaria and employing a ‘ one blood drop two diseases’ approach could optimize patient encounters and help reduce inequalities in access to diabetes diagnosis in malaria-endemic geographies. This proposal requires feasibility, implementation and cost-effectiveness studies before consideration for political adoption.