Tuberculosis non-communicable disease comorbidity and multimorbidity in public primary care patients in South Africa

Abstract

BackgroundLittle is known about the prevalence of non-communicable disease (NCD) multimorbidity among tuberculosis (TB) patients in Africa.Aim and settingThe aim of this study was to assess the prevalence of NCD multimorbidity, its pattern and impact on adverse health outcomes among patients with TB in public primary care in three selected districts of South Africa.MethodsIn a cross-sectional survey, new TB and TB retreatment patients were interviewed, and medical records assessed in consecutive sampling within 1 month of anti-TB treatment. The sample included 4207 (54.5% men and 45.5% women) TB patients from 42 primary care clinics in three districts. Multimorbidity was measured as the simultaneous presence of two or more of 10 chronic conditions, including myocardial infarction or angina pectoris, arthritis, asthma, chronic lung disease, diabetes mellitus, hypertension, dyslipidaemia, malignant neoplasms, tobacco and alcohol-use disorder.ResultsThe prevalence of comorbidity (with one NCD) was 26.9% and multimorbidity (with two or more NCDs) was 25.3%. We identified three patterns of multimorbidity: (1) cardio-metabolic disorders; (2) respiratory disorders, arthritis and cancer; and (3) substance-use disorders. The likelihood of multimorbidity was higher in older age, among men, and was lower in those with higher education and socio-economic status. The prevalence of physical health decreased, and common mental disorders and post-traumatic stress disorder increased with an increase in the number of chronic conditions.ConclusionHigh NCD comorbidity and multimorbidity were found among TB patients predicted by socio-economic disparity.

Cardiometabolic risk factors among patients with tuberculosis attending tuberculosis treatment centers in Nepal

“…In this study, literate patients with TB showed reduced risk of cardiometabolic diseases and echoes with previous studies from Nepal [ 29 ]. Our findings are also consistent with South African study where the risk of cardiometabolic disorders was higher among men, and was lower in those with higher education and socio-economic status [ 33 ]. The fact that higher education, in general, might have led to increased awareness regarding the NCDs such as diabetes and hypertension and thus the personal modification in food and lifestyle related behavior could be one of the mechanisms to explain the finding.…”

Management of hospitalized drug sensitive pulmonary tuberculosis patients during the Hajj mass gathering: A cross sectional study

“…This is in accordance with global and Hajj-related data and established risk factors for TB [1,7,10,12]. However, the prevalence of coexisting chronic diseases (63%, 17/27) among TB patients, especially diabetes, was higher than that reported internationally as well as previous studies among Hajj pilgrims with TB [7,[12][13][14]. The presence of chronic diseases, increases the risk of TB disease, predisposes to severe illness and complicates TB treatment [1,12].…”

Multimorbidity of chronic non-communicable diseases in low- and middle-income countries: A scoping review

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