Clinical Research Department, London School of Hygiene & Tropical Medicine, London, United Kingdom.
The Health Research Unit Zimbabwe, Biomedical Research and Training Institute, Harare, Zimbabwe.
PLoS Med. 2024 Sep 16;21(9):e1004452. doi: 10.1371/journal.pmed.1004452. eCollection 2024 Sep.
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.
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.
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.
由于共同的社会和结构性风险因素，受结核病影响的家庭中的人可能面临更高的慢性疾病风险；同时，结核病筛查可能是干预的机会。我们旨在描述 3 个非洲国家中受结核病影响的家庭成员中艾滋病毒、营养障碍和非传染性疾病（NCD）的患病率。
这是一项多国队列研究的一部分，我们对莫桑比克、坦桑尼亚和津巴布韦的受结核病影响的家庭中年龄≥10 岁的成员进行了结核病、艾滋病毒、营养障碍（体重不足、贫血、超重/肥胖）和 NCD（糖尿病、高血压和慢性肺病）筛查。我们描述了这些疾病的患病率、它们在个体（多种疾病）中的共存情况以及家庭层面的聚集情况。在招募的 2109 名家庭接触者中，有 93%（n=1958，来自 786 个家庭）完成了完整的数据收集并纳入分析。62%为女性，中位年龄为 27 岁，0.7%（n=14）被诊断为同时患有肺结核。6%的家庭成员（n=120）曾患有结核病，15%（n=294）携带艾滋病毒，10%（n=194）患有慢性肺病，18%（n=347）患有贫血。根据 HbA1c 标准，9%的成年人（n=127）患有糖尿病，32%（n=439）患有高血压。根据身体质量指数标准，18%的家庭成员（n=341）体重不足，29%（n=549）超重或肥胖。几乎一半的家庭成员（n=658）至少有一种可改变的结核病风险因素。61%的成年人（n=822）至少有一种慢性疾病，1/4的人患有多种疾病。虽然大多数艾滋病毒感染者知道自己的状况并正在接受治疗，但患有 NCD 的人通常未被诊断和未接受治疗。本研究的局限性包括使用即时检测 HbA1c 来定义糖尿病和基于单日测量值来定义高血压。
受结核病影响的家庭也面临着多种其他健康挑战。将结核病筛查方法整合起来，可能是发现和治疗的机会，包括优先考虑结核病风险最高的个体接受预防治疗。
