The pattern of comorbidity and its prevalence among drug-resistant tuberculosis patients at treatment initiation in Lagos, Nigeria

Abstract

Background Multimorbidity is increasingly being recognized as a serious public health concern in the control of both drug-susceptible and drug-resistant tuberculosis (DR-TB). This study assessed the pattern of comorbidities and their prevalence in DR-TB patients at treatment initiation in Lagos, Nigeria. Methods A cross-sectional study was conducted. The baseline laboratory records (human immunodeficiency virus [HIV] status, fasting blood sugar, audiometry, thyroid function tests, serum electrolyte, haemoglobin level and pregnancy test) of DR-TB patients initiated on treatment in Lagos, Nigeria between 1 August 2014 and 31 March 2017 were reviewed. Results A total of 565 DR-TB patients’ laboratory records were reviewed, of which 397 (70.3%) had comorbidities. The proportion with one, two, three and four comorbidities was 60.2%, 29.7%, 8.1% and 2.0%, respectively. Anaemia was the most common (48.1%) comorbid condition, while anaemia and hypokalaemia (7.3%), anaemia and hypothyroidism (6.5%) and anaemia and HIV (5%) were most common among patients with more than one comorbid condition. DR-TB patients with comorbidity were significantly older (34.8±12.3 y) than those without comorbidity (32.0±12.8 y) (p=0.038). Of the 176 females in the reproductive age group, 8 (4.5%) were pregnant at baseline. Conclusions The prevalence of comorbidity among DR-TB patients was high. There is a need for the national TB program to expand its DR-TB council of experts and also integrate reproductive health services into DR-TB management in Nigeria.

Emerging Characteristic Profile of Patients on Multi-Drug Resistant Tuberculosis Treatment in Oyo State Drug-Resistant Tuberculosis Treatment Centres

“…The finding of this study shows that the prevalence of comorbidity of anemia with DR-TB patients was high, with 68.5% of the patients being anemic. This is similar to prevous report [28][29][30][31][32][33][34][35], who reported a prevalence of 70.2% compared with 93.6% reported from a Nigerian study that profiled the haematological indices of pretreatment smear-positive DSTB patients [36], but high compared with 51.2% from another study from Ethiopia that compared blood levels before and after DS-TB treatment. The variation in the pattern of anemia recorded may result from the respondents' different geographical backgrounds and socioeconomic statuses.…”

Whole genome sequencing of clinical samples reveals extensively drug resistant tuberculosis (XDR TB) strains from the Beijing lineage in Nigeria, West Africa

“…Just as many other West African countries, Nigeria has deployed rapid molecular techniques to detect RR-TB and MDR TB by using Xpert®MTB/Rif assay (Cephid, USA) and GenoType MTDRplus Line Probe Assay (Hain Lifescience GmbH, Germany) 18 . However, these techniques come with limitations when compared to whole genome sequencing (WGS), as the latter can detect drug resistant mutations outside the target zone of rapid tests and produce much more reliable and robust drug resistance profile of TB 19 .…”

Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries

“…Despite this, evidence on NCD multimorbidity in people with TB in these areas remains scarce, with numerous gaps and limitations in the literature. First, most research considering TB multimorbidity-presence of TB alongside one or more chronic conditions-has included small-scale studies [26], been restricted to a single country [4,27,28], or only considered one comorbid chronic condition [29,30]. Second, limited information is available on the actual patterns and risks of multimorbidity compared to the general population and on the burden of disease associated with TB multimorbidity [31].…”