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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International Union Against Tuberculosis and Lung Disease (The Union)
2024-05-01
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| author | 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 |
| author_facet | 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 |
| author_sort | The Kenya, Uganda, Zambia, and Zimbabwe TB Disability Study Group (members listed here in alphabetical order): |
| collection | DOAJ |
| description | 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. |
| format | Article |
| id | doaj-art-4578425c341f400e87a427a943027262 |
| institution | Kabale University |
| issn | 3005-7590 |
| language | English |
| publishDate | 2024-05-01 |
| publisher | International Union Against Tuberculosis and Lung Disease (The Union) |
| record_format | Article |
| series | IJTLD Open |
| spelling | doaj-art-4578425c341f400e87a427a9430272622025-01-21T10:40:46ZengInternational Union Against Tuberculosis and Lung Disease (The Union)IJTLD Open3005-75902024-05-011519720510.5588/ijtldopen.24.00822Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and ZimbabweThe Kenya, Uganda, Zambia, and Zimbabwe TB Disability Study Group (members listed here in alphabetical order):S.A. Adakun0F.M. Banda1A. Bloom2M. Bochnowicz3J. Chakaya4A. Chansa5H. Chiguvare6R. Chimzizi7C. Colvin8J.P. Dongo9A. Durena10C. Duri11R. Edmund12A.D. Harries13I. Kathure14F.N. Kavenga15Y. Lin16H. Luzze17I. Mbithi18M. Mputu19A. Mubanga20D. Nair21M. Ngwenya22B. Okotu23P. Owiti24A. Owuor25P. Thekkur26C. Timire27S. Turyahabwe28E. Tweyongyere29M. YaDiul30R. Zachariah31K. Zimba32Mulago National Referral Hospital, Kampala, Uganda;University Teaching Hospital, Ministry of Health, Lusaka, Zambia;Credence, Contractor for USAID Health Training, Advisory, and Support Contract (GHTASC), Washington DC, USA;Credence, Contractor for USAID Health Training, Advisory, and Support Contract (GHTASC), Washington DC, USA;Department of Medicine, Therapeutics, Dermatology and Psychiatry Kenyatta University, Nairobi,Ndola Teaching Hospital, Ministry of Health, Ndola, Zambia;United States Agency for International Development (USAID), Harare, Zimbabwe;Ministry of Health, USAID Long-term Exceptional Technical Assistance Project, Genesis, Lusaka, Zambia;United States Agency for International Development (USAID), Harare, Zimbabwe;International Union Against Tuberculosis and Lung Disease (The Union) Uganda Office, Kampala, Uganda;United States Agency for International Development (USAID), Harare, Zimbabwe;Directorate of Health Services, Harare City Council, Harare, Zimbabwe;United States Agency for International Development (USAID), Harare, Zimbabwe;The Union, Paris, France;Ministry of Health, Division of National TB, Leprosy and Lung Disease Programme, Nairobi, Kenya;Ministry of Health and Child Care, AIDS and TB Department, Harare, Zimbabwe;The Union, Paris, France;National Tuberculosis and Leprosy Programme, Ministry of Health, Kampala, Uganda;Respiratory Society of Kenya, Nairobi, Kenya;National Tuberculosis Programme, Ministry of Health/USAID TBLON, Lusaka; Zambia;National Tuberculosis Programme, Ministry of Health/USAID TBLON, Lusaka; Zambia;The Union, Paris, France;Ministry of Health and Child Care, AIDS and TB Department, Harare, Zimbabwe;Ministry of Health, Division of National TB, Leprosy and Lung Disease Programme, Nairobi, Kenya;USAID, Health, Population and Nutrition Office, Kenya and East Africa, Nairobi,Kenyatta National Hospital, Nairobi, Kenya;The Union, Paris, France;The Union, Paris, France;National Tuberculosis and Leprosy Programme, Ministry of Health, Kampala, Uganda;National Tuberculosis and Leprosy Programme, Ministry of Health, Kampala, Uganda;USAID, Washington DC, USA;UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland;USAID, Lusaka, ZambiaBACKGROUND: 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.https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000005/art00002tb-associated disabilitytb-associated lung diseasereal-time operational researchsort ituniversal health coverage |
| spellingShingle | 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 Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe IJTLD Open tb-associated disability tb-associated lung disease real-time operational research sort it universal health coverage |
| title | Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe |
| title_full | Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe |
| title_fullStr | Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe |
| title_full_unstemmed | Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe |
| title_short | Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe |
| title_sort | disability comorbidities and risk determinants at end of tb treatment in kenya uganda zambia and zimbabwe |
| topic | tb-associated disability tb-associated lung disease real-time operational research sort it universal health coverage |
| url | https://www.ingentaconnect.com/contentone/iuatld/ijtldo/2024/00000001/00000005/art00002 |
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