Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe

Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe

BACKGROUND: We examined the feasibility of assessing and referring adults successfully completing TB treatment for comorbidities, risk determinants and disability in health facilities in Kenya, Uganda, Zambia and Zimbabwe. METHODS: This was a cross-sectional study within national TB programmes. RESU...

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Main Authors: The Kenya, Uganda, Zambia, and Zimbabwe TB Disability Study Group (members listed here in alphabetical order):, S.A. Adakun, F.M. Banda, A. Bloom, M. Bochnowicz, J. Chakaya, A. Chansa, H. Chiguvare, R. Chimzizi, C. Colvin, J.P. Dongo, A. Durena, C. Duri, R. Edmund, A.D. Harries, I. Kathure, F.N. Kavenga, Y. Lin, H. Luzze, I. Mbithi, M. Mputu, A. Mubanga, D. Nair, M. Ngwenya, B. Okotu, P. Owiti, A. Owuor, P. Thekkur, C. Timire, S. Turyahabwe, E. Tweyongyere, M. YaDiul, R. Zachariah, K. Zimba
Format: Article
Language:English
Published: International Union Against Tuberculosis and Lung Disease (The Union) 2024-05-01
Series:IJTLD Open
Subjects:
tb-associated disability
tb-associated lung disease
real-time operational research
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universal health coverage
Online Access:https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000005/art00002
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Summary:BACKGROUND: We examined the feasibility of assessing and referring adults successfully completing TB treatment for comorbidities, risk determinants and disability in health facilities in Kenya, Uganda, Zambia and Zimbabwe. METHODS: This was a cross-sectional study within national TB programmes. RESULTS: Health workers assessed 1,063 patients (78% of eligible) in a median of 22 min [IQR 16–35] and found it useful and feasible to accomplish in addition to other responsibilities. For comorbidities, 476 (44%) had HIV co-infection, 172 (16%) had high blood pressure (newly detected in 124), 43 (4%) had mental health disorders (newly detected in 33) and 36 (3%) had diabetes mellitus. The most common risk determinants were ‘probable alcohol dependence’ (15%) and malnutrition (14%). Disability, defined as walking <400 m in 6 min, was found in 151/882 (17%). Overall, 763 (72%) patients had at least one comorbidity, risk determinant and/or disability. At least two-thirds of eligible patients were referred for care, although 80% of those with disability needed referral outside their original health facility. CONCLUSIONS: Seven in 10 patients completing TB treatment had at least one comorbidity, risk determinant and/or disability. This emphasises the need for offering early patient-centred care, including pulmonary rehabilitation, to improve quality of life, reduce TB recurrence and increase long-term survival.
ISSN:3005-7590

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