Magha Chefor, Nchang Lucy Cho, Weldeslassie Michael, Nkimbeng Desmond Akumtoh, Tchatat Nancielle Mbiatong, Meriki Henry Dilonga, Deribe Kebede, Nietcho Frank Noel, Foyet Juluis Visnel, Fombad Fanny Fri, Katcho Tatiana Djikeussi, Cho Jerome Fru, Gebremeskel Eyoab Iyasu, Waddell Simon J, Bobosha Kidist, Newport Melanie J, Hoerauf Achim, Ritter Manuel, Wanji Samuel
Parasites and Vector Research Unit (PAVBRU), Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
Research Foundation for Tropical Diseases and the Environment (REFOTDE), Buea, Cameroon.
Front Tuberc. 2024 Oct 2;2. doi: 10.3389/ftubr.2024.1433856.
Comorbid non-communicable diseases (NCDs) like diabetes, cardiovascular diseases (CVD), kidney diseases, and hypertension, could have implications for tuberculosis (TB) treatment management and increase the disease burden amongst active TB patients.
This cross-sectional study aimed at profiling comorbidities amongst sputum-positive TB patients in the South West and Littoral regions of Cameroon and was relevant for improving disease management and public health interventions. Diabetes was defined by elevated blood glucose, body mass index (underweight: <18.5 kg/m, normal: 18.5-<25.0 kg/m, overweight: 25-<30 kg/m and obese: ≥30.0 kg/m) and hypertension by elevated blood pressure levels (i.e., systolic ≥130 mmHg or diastolic ≥80 mmHg). Socio-demographic and clinical data were collected using case report forms. Descriptive analysis was performed, bivariate logistic regression analysis was computed with at least one comorbidity as the dependent variable (global model) and a multivariable logistic regression analysis was done to provide adjusted odds ratios (final model). The covariate with the highest -value was removed until < 0.25 cut-off, using R software version 4.3.1. -value <0.05 at 95% confidence interval was considered statistically significant.
Five hundred and forty-nine sputum-positive microscopically confirmed active TB patients were enrolled into this study. Two-thirds (65.8%) of the total patients were male. Overall, 56 sputum-positive TB patients had at least one non-communicable disease, thus a prevalence of 10.2% (95% CI = 7.9-13.0). The most frequently recorded NCD was diabetes 4.4% (95% CI = 3.1-6.7) followed by kidney disease 2% (95% CI = 1.1-3.6), hypertension 0.9% (95% CI = 0.4-2.2), and CVD 0.91% (95% CI = 0.4-2.2). Three TB patients (0.6%) had all four comorbidities examined. Age group ( < 0.001), and level of education ( = 0.049) were factors significantly associated with having at least one comorbidity.
Our findings showed that diabetes was significantly the most prevalent comorbid NCD amongst sputum-positive TB patients ( < 0.001). HIV status, occupation, body mass index (BMI), and alcohol intake were not significantly associated with having at least one comorbidity. Implementing public health intervention programmes such as systematic screening of TB patients for NCDs especially diabetes is highly recommended for better control of these diseases.
糖尿病、心血管疾病、肾脏疾病和高血压等合并存在的非传染性疾病，可能会对结核病治疗管理产生影响，并增加活动性结核病患者的疾病负担。
这项横断面研究旨在分析喀麦隆西南和滨海地区痰涂片阳性结核病患者的合并症情况，这对于改善疾病管理和公共卫生干预措施具有重要意义。糖尿病的定义为血糖升高、体重指数（体重过轻：<18.5kg/m，正常：18.5-<25.0kg/m，超重：25-<30kg/m，肥胖：≥30.0kg/m），高血压的定义为血压水平升高（即收缩压≥130mmHg或舒张压≥80mmHg）。使用病例报告表收集社会人口统计学和临床数据。进行描述性分析，以至少一种合并症作为因变量进行二元逻辑回归分析（全局模型），并进行多变量逻辑回归分析以提供调整后的比值比（最终模型）。使用R软件版本4.3.1，去除具有最高p值的协变量，直到p值<0.25截止值。95%置信区间下p值<0.05被认为具有统计学意义。
549例痰涂片阳性且经显微镜确诊的活动性结核病患者纳入本研究。三分之二（65.8%）的患者为男性。总体而言，56例痰涂片阳性结核病患者至少患有一种非传染性疾病，患病率为10.2%（95%CI=7.9-13.0）。记录最频繁的非传染性疾病是糖尿病4.4%（95%CI=3.1-6.7），其次是肾脏疾病2%（95%CI=1.1-3.6）、高血压0.9%（95%CI=0.4-2.2）和心血管疾病0.91%（95%CI=0.4-2.2）。3例结核病患者（0.6%）患有所有四种被检查的合并症。年龄组（p<0.001）和教育水平（p=0.049）是与至少患有一种合并症显著相关的因素。
我们的研究结果表明，糖尿病是痰涂片阳性结核病患者中最普遍的合并存在的非传染性疾病（p<0.001）。艾滋病毒感染状况、职业、体重指数（BMI）和酒精摄入量与至少患有一种合并症无显著关联。强烈建议实施公共卫生干预计划，如对结核病患者进行非传染性疾病尤其是糖尿病的系统筛查，以更好地控制这些疾病。
