HIV, malnutrition, and noncommunicable disease epidemics among tuberculosis-affected households in east and southern Africa: A cross-sectional analysis of the ERASE-TB cohort.

Autor: Calderwood CJ; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom.; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe., Marambire ET; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.; CIHLMU Center for International Health, University Hospital, LMU Munich, Munich, Germany., Larsson L; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.; Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany., Banze D; CIHLMU Center for International Health, University Hospital, LMU Munich, Munich, Germany.; Instituto Nacional de Saúde (INS), Marracuene, Mozambique., Mfinanga A; CIHLMU Center for International Health, University Hospital, LMU Munich, Munich, Germany.; National Institute for Medical Research-Mbeya Medical Research Centre, Mbeya, Tanzania., Nhamuave C; Instituto Nacional de Saúde (INS), Marracuene, Mozambique., Appalarowthu T; Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany., Mugava M; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe., Ribeiro J; Instituto Nacional de Saúde (INS), Marracuene, Mozambique., Towo PE; National Institute for Medical Research-Mbeya Medical Research Centre, Mbeya, Tanzania., Madziva K; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe., Dixon J; Department of Global Health and Development, London School of Hygiene & Tropical Medicine, London, United Kingdom., Held K; Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.; German Centre for Infection Research (DZIF), partner site Munich, Germany.; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany., Minja LT; National Institute for Medical Research-Mbeya Medical Research Centre, Mbeya, Tanzania., Mutsvangwa J; Biomedical Research and Training Institute, Harare, Zimbabwe., Khosa C; Instituto Nacional de Saúde (INS), Marracuene, Mozambique., Heinrich N; Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.; German Centre for Infection Research (DZIF), partner site Munich, Germany.; Fraunhofer Institute for Translational Medicine and Pharmacology ITMP, Immunology, Infection and Pandemic Research, Munich, Germany., Fielding K; TB Centre, London School of Hygiene & Tropical Medicine, London, United Kingdom., Kranzer K; Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom.; The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.; Division of Infectious Diseases and Tropical Medicine, University Hospital, LMU Munich, Munich, Germany.; German Centre for Infection Research (DZIF), partner site Munich, Germany.
Jazyk: angličtina
Zdroj: PLoS medicine [PLoS Med] 2024 Sep 16; Vol. 21 (9), pp. e1004452. Date of Electronic Publication: 2024 Sep 16 (Print Publication: 2024).
DOI: 10.1371/journal.pmed.1004452
Abstrakt: Background: As a result of shared social and structural risk factors, people in households affected by tuberculosis may have an increased risk of chronic conditions; at the same time, tuberculosis screening may be an opportunity for interventions. We sought to describe the prevalence of HIV, nutritional disorders, and noncommunicable diseases (NCDs) among members of tuberculosis-affected households in 3 African countries.
Methods and Findings: A part of a multicountry cohort study, we screened for tuberculosis, HIV, nutritional disorders (underweight, anaemia, overweight/obesity), and NCDs (diabetes, hypertension, and chronic lung disease) among members of tuberculosis-affected households aged ≥10 years in Mozambique, Tanzania, and Zimbabwe. We describe the prevalence of these conditions, their co-occurence within individuals (multimorbidity) and household-level clustering. Of 2,109 household contacts recruited, 93% (n = 1,958, from 786 households) had complete data and were included in the analysis. Sixty-two percent were female, median age was 27 years, and 0.7% (n = 14) were diagnosed with co-prevalent tuberculosis. Six percent of household members (n = 120) had previous tuberculosis, 15% (n = 294) were living with HIV, 10% (n = 194) had chronic lung disease, and 18% (n = 347) were anaemic. Nine percent of adults (n = 127) had diabetes by HbA1c criteria, 32% (n = 439) had hypertension. By body mass index criteria, 18% household members (n = 341) were underweight while 29% (n = 549) were overweight or obese. Almost half the household members (n = 658) had at least 1 modifiable tuberculosis risk factor. Sixty-one percent of adults (n = 822) had at least 1 chronic condition, 1 in 4 had multimorbidity. While most people with HIV knew their status and were on treatment, people with NCDs were usually undiagnosed and untreated. Limitations of this study include use of point-of-care HbA1c for definition of diabetes and definition of hypertension based on single-day measurements.
Conclusions: Households affected by tuberculosis also face multiple other health challenges. Integrated approaches to tuberculosis screening may represent an opportunity for identification and treatment, including prioritisation of individuals at highest risk for tuberculosis to receive preventive therapy.
Competing Interests: EDCTP Grant funding for this research to NH’s institution. DZIF Grant funding for this research to NH’s institution. Funding by Beckman Coulter to NH’s institution.
(Copyright: © 2024 Calderwood et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze: MEDLINE
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