Non-communicable disease co-morbidity and associated factors in tuberculosis patients: A cross-sectional study in Gabon

B R Adegbite; J R Edoa; Jbp Agbo Achimi Abdul; M Epola; C Mevyann; J C Dejon-Agobé; J F Zinsou; Y J Honkpehedji; S G Mpagama; A S Alabi; P G Kremsner; K Klipstein-Grobusch; A A Adegnika; M P Grobusch

doi:10.1016/j.eclinm.2022.101316

Non-communicable disease co-morbidity and associated factors in tuberculosis patients: A cross-sectional study in Gabon

EClinicalMedicine. 2022 Feb 27:45:101316. doi: 10.1016/j.eclinm.2022.101316. eCollection 2022 Mar.

Authors

B R Adegbite^{1

2

3}, J R Edoa^{1

2

3}, Jbp Agbo Achimi Abdul¹, M Epola¹, C Mevyann¹, J C Dejon-Agobé^{1

2

3}, J F Zinsou^{1

3

4}, Y J Honkpehedji^{1

3

4}, S G Mpagama⁵, A S Alabi^{1

3}, P G Kremsner^{1

3}, K Klipstein-Grobusch^{6

7}, A A Adegnika^{1

3

4}, M P Grobusch^{1

2

3

8

9}

Affiliations

¹ German Center for Infection Research, Centre de Recherches Médicales de Lambaréné and African Partner Institution, Lambaréné, Gabon.
² Center of Tropical Medicine and Travel Medicine, Department of Infectious Diseases, location AMC, Amsterdam Public Health, Amsterdam Infection and Immunity, University of Amsterdam, Amsterdam University Medical Centers, location AMC, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands.
³ Universität Tübingen and German Center for Infection Research, Institut für Tropenmedizin, Tübingen, Germany.
⁴ Department of Parasitology, Leiden University Medical Center, Leiden, the Netherlands.
⁵ Kibong'oto Infectious Diseases Hospital - Sanya Juu Siha/Kilimanjaro Clinical Research Institute Kilimanjaro Tanzania, Mae Street, Lomakaa Road, Siha Kilimanjaro, Tanzania.
⁶ Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
⁷ Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
⁸ Masanga Medical Research Unit (MMRU), Masanga, Sierra Leone.
⁹ Institute of Infectious Diseases and Molecular Medicine (IDM), University of Cape Town, Cape Town, South Africa.

Abstract

Background: There are only limited data from resource-limited settings available on the prevalence of non-communicable diseases and associated risk factors of tuberculosis patients. This study investigated non-communicable disease co-morbidity in tuberculosis patients from Moyen Ogooué Province, Gabon.

Methods: All patients aged 18 years or older consulting for tuberculosis (TB) symptoms in Gabon's Moyen Ogooué province and neighbouring provinces from November 2018 to November 2020 were screened for diabetes mellitus, hypertension, and risk factors thereof (obesity, dyslipidaemia, smoking and alcohol consumption). Logistic regression was performed to identify factors associated with TB-diabetes and TB-hypertension co-morbidities.

Findings: Of 583 patients included, 227 (39%) were diagnosed with tuberculosis. In tuberculosis-confirmed patients, the prevalences of hypertension and diabetes were 16·3% and 12·8%, respectively. The prevalence of diabetes was twice as high in tuberculosis patients compared to non-tuberculosis patients. Factors independently associated with hypertension-tuberculosis co-morbidity were age >55 years (aOR=8·5, 95% CI 2·43, 32·6), age 45-54 years (aOR=4.9, 95%CI 1.3-19.8), and moderate alcohol consumption (aOR=2·4; 95% CI 1·02- 5·9), respectively. For diabetes-tuberculosis co-morbidity, age >55 years was positively (aOR=9·13; 95% CI 2·4-39·15), and moderate alcohol consumption inversely associated (aOR=0·26, 95% CI 0·08- 0·73). One-hundred-and-four (46%) of the tuberculosis patients had at least either dyslipidaemia, hypertension, diabetes, or obesity with a majority of newly-diagnosed hypertension and diabetes.

Interpretation: Integration of screening of non-communicable diseases and their risk factors during TB assessment for early diagnosis, treatment initiation and chronic care management for better health outcomes should be implemented in all tuberculosis healthcare facilities.

Funding: This study was supported by WHO AFRO/TDR/EDCTP (2019/893,805) and Deutsches Zentrum für Infektiologie (DZIF/ TTU 02.812).

Keywords: Co-morbidity; Diabetes; Hypertension; Non-communicable diseases; Obesity; Tuberculosis.