Relationship between multimorbidity and the outcome of the treatment for pulmonary tuberculosis

Abstract

<jats:p>ABSTRACT Objective: To analyze the influence of multimorbidity on the treatment outcome of new cases of pulmonary tuberculosis. Method: A population-based analytical study, using secondary data, collected from the database of the Notification Disease Information System, of new cases of pulmonary tuberculosis in the state of Rio Grande do Sul between 2013 and 2016. The relationship between multimorbidity and the outcome was analyzed with Multinomial Logistic Regression. Results: Multimorbidity was present in 37.0% of the cases. Of these, the Relative Risk (RR) was 1.7 for treatment abandonment and 2.9 for death. HIV had an RR of 2.1 for dropout and of 3.9 for death. The higher the number of comorbidities, the higher the RR for unfavorable outcomes. Conclusion: Multimorbidity influences on unfavorable outcomes of the treatment for tuberculosis.</jats:p>

Prevalence, clusters, and burden of complex tuberculosis multimorbidity in low- and middle-income countries: a systematic review and meta-analysis

“…This is in line with a study that found increased risks of adverse outcomes with increasing number of comorbidities. [13]…”

“…[9] In high-income countries (HICs) 30% of adults experience multimorbidity, and its prevalence is also increasing in low-and middle-income countries (LMICs), [10] where NCDs are on the rise [11] and CCDs such as HIV remain a major public health issue. [12] Multimorbidity represents a substantial burden for individuals, increasing their risk of adverse events, [13,14] and puts health systems under strain, [9] particularly in LMICs.…”

“…[17] The co-occurrence of TB with individual chronic conditions is associated with a range of adverse outcomes, such as higher odds of unsuccessful treatment, non-adherence, or mortality. [18][19][20] Furthermore, people with TB and an additional chronic condition tend to have significantly worse treatment outcomes than people with TB alone; [13,[20][21][22] and people with TB and multiple chronic conditions, i.e. complex TB multimorbidity (cTBMM), [23] may be at a higher risk of death than people with TB alone or TB with only one chronic condition.…”

“…complex TB multimorbidity (cTBMM), [23] may be at a higher risk of death than people with TB alone or TB with only one chronic condition. [13] While reviews have identified the prevalence and risks associated with TB and individual chronic conditions, there has been no systematic review summarising the evidence concerning the prevalence and associated burden of cTBMM.…”

Tuberculosis and comorbidities: treatment challenges in patients with comorbid diabetes mellitus and depression

“…Multiple studies indicate that the presence of comorbidities in TB patients is associated with unfavorable outcomes of the TB treatment. 11 Therefore, the coexistence of certain non-communicable diseases with TB represent several health challenges, requiring a focus on multidisciplinary collaboration and integrated strategies, to accurately deal with this double burden of disease. 12 …”