Predictors of Tuberculosis and Non-Communicable Disease Comorbidities Among Newly Enrolled Tuberculosis Patients, Southern Ethiopia

Abstract

Mengistu Handiso Nunemo,1 Kassa Daka Gidebo,2 Eskinder Wolka Woticha,2 Yohannes Kebede Lemu3 1Department of Public Health, Wachemo University, Hossana, Central Region, Ethiopia; 2Department of Public Health, Wolaita Sodo University, Wolaita, South Region, Ethiopia; 3Department of Health, Behaviour and Society, Jimma University, Jimma, Oromia Region, EthiopiaCorrespondence: Mengistu Handiso Nunemo, Department of Public Health, Wachemo University, Po.Box: 667, Hosanna, Centeral Region, Ethiopia, Tel + 251 916357401, Email [email protected]: Non-communicable diseases are comorbid with tuberculosis, however only a few record review based studies have been conducted, which are more concentrated on elevated glucose levels. This study aimed to assess non-communicable disease comorbidity and its predictors among tuberculosis patients.Methods: A prospective cross-sectional study design was used and the data were collected by a previously validated tool from a sample of 443 tuberculosis patients using cluster random sampling methods. Multinomial logistic regression was interpreted by relative risk to predict the association of comorbidity status with independent variables.Results: The majority (87.81%) of TB patients were not comorbid with NCDs. The prevalence of hypertension and diabetes mellitus among tuberculosis patients were 6.55%, and 5.64%, respectively. The people who had a risk score > 8 were 6.47 times more likely to have tuberculosis comorbid with one non-communicable disease compared to those with a risk score ≤ 8. The relative risk of tuberculosis patients with BMI > 25 is 3.33 times compared to those with a BMI < 23 of being comorbid with one non-communicable disease vs tuberculosis patients without non-communicable diseases. Those tuberculosis patients with an awareness of non-communicable disease comorbidities are 9.33 times more likely to have tuberculosis with multi-comorbidities compared to those who are unaware.Conclusion: The majority of TB patients were not comorbid with NCDs. The person’s weight, family size of more than five, monthly income > 3000 birr, risk score > 8 and BMI > 25 significantly predict comorbidity with one non-communicable disease compared to those without a comorbidity. The presence of non-communicable disease comorbidity, treatment awareness, and being aged 50+ years significantly predict the presence of multi-comorbidities compared to those without comorbidity. For early detection and management of both diseases, establishing bidirectional screening platforms in tuberculosis care programs is urgently required.Plain Language Summary: Non-communicable diseases are comorbid with tuberculosis, however, only a few record review based studies have been conducted, which are more concentrated on elevated glucose levels.This is a former prospective cross-sectional study of non-communicable disease comorbidities and their predictors among tuberculosis patients using the two stages of the WHO step-wise screening procedure.The majority (87.81%) of TB patients were not comorbid with NCDs, 7.22% were comorbid with one NCD and 4.97% were multi-comorbid. The prevalence of hypertension and diabetes mellitus among tuberculosis patients were 6.55%, and 5.64%, respectively. The person’s weight, family size of more than five, monthly income > 3000 birr, risk score > 8 and BMI > 25 significantly predict the comorbidity with one non-communicable disease related to those without comorbidity. The presence of non-communicable disease comorbidity, treatment awareness, and being aged 50+ years significantly predicted the presence of multi-comorbidity compared to those without comorbidity. For early detection and management of both diseases, establishing bidirectional screening platforms in tuberculosis care programs is urgently required.Keywords: comorbidity, non-communicable disease, tuberculosis, prevalence, predictor