Cardio-metabolic risk factors among patients with tuberculosis attending tuberculosis treatment centers in Nepal

Abstract

Background The co-morbidity of cardio-metabolic diseases in patients with Tuberculosis adds a significant burden in current health systems in developing countries including Nepal. The main objective of this study was to explore cardio-metabolic risk factors among patients with Tuberculosis. Methods This was a cross-sectional study conducted in 12 tuberculosis centers from eight districts of Nepal between May and July 2017. A total of 238 patients with tuberculosis who visited Tuberculosis centers for Directly Observed Treatment Short-course therapy participated in this study. Interviews with participants were conducted using a structured questionnaire and were supplemented by anthropometric measurements and on site blood glucose tests. Data were analyzed using descriptive and inferential statistics. Results Among 221 study participants, 138 (62.4%) had new smear positive pulmonary tuberculosis, 24 (10.9%) had new smear negative pulmonary tuberculosis and 34 (15.4%) had new extra pulmonary tuberculosis. Overall, 43.1% of the patients with tuberculosis had at least one cardio-metabolic risk factor. The prevalence of at least one cardio-metabolic risk factor was more in male than female (47.8% versus 33.8%). Prevalence of tobacco (18.9% versus 4.8%), and alcohol (12.6% versus 6.5%) use was proportionately higher in male compared to female. The prevalence of hypertension (17% vs. 21%) and obesity (11.9% vs. 12.9%) was lower in male compared to females. Female (AOR=0.47; CI: 0.23-0.94), those from Gandaki Province (AOR=0.32; CI: 0.13-0.79) and literate (AOR=0.49; CI: 0.25-0.96) had reduced risk of cardio-metabolic disease risk factors. Conclusions This study highlights the role of gender and socio-demographic characteristics associated with the risk of cardio-metabolic diseases in patients with Tuberculosis. The findings from this study can guide medical practitioners and policy makers to consider clinical suspicion, diagnosis and treatment. National treatment guideline can benefit by integrating the management of non-communicable diseases in Tuberculosis treatment centers.