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

Journal: IJTLD open

Volume: 1

Issue: 5

Year of Publication: 

Affiliated Institutions:  Mulago 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. 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. International Union Against Tuberculosis and Lung Disease (The Union) Uganda Office, Kampala, Uganda. Directorate of Health Services, Harare City Council, 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. 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. USAID, Health, Population and Nutrition Office, Kenya and East Africa, Nairobi. Kenyatta National Hospital, Nairobi, Kenya. 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, Zambia.

Abstract summary 

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.This was a cross-sectional study within national TB programmes.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.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.

Authors & Co-authors:  Adakun S A SA Banda F M FM Bloom A A Bochnowicz M M Chakaya J J Chansa A A Chiguvare H H Chimzizi R R Colvin C C Dongo J P JP Durena A A Duri C C Edmund R R Harries A D AD Kathure I I Kavenga F N FN Lin Y Y Luzze H H Mbithi I I Mputu M M Mubanga A A Nair D D Ngwenya M M Okotu B B Owiti P P Owuor A A Thekkur P P Timire C C Turyahabwe S S Tweyongyere E E YaDiul M M Zachariah R R Zimba K K

Study Outcome 

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Statistics
Citations :  World Health Organization . Global tuberculosis report, 2023. Geneva, Switzerland: WHO, 2023.
Authors :  34
Identifiers
Doi : 10.5588/ijtldopen.24.0082
SSN : 3005-7590
Study Population
Male,Female
Mesh Terms
Other Terms
Real-time operational research;SORT IT;TB-associated disability;TB-associated lung disease;Universal health coverage
Study Design
Cross Sectional Study
Study Approach
Country of Study
Uganda
Publication Country
France