TB Multimorbidity

People with tuberculosis (TB) often have other long-term conditions like depression, diabetes, and HIV, as well as risk factors such as alcohol use, malnutrition, and smoking, which worsen health outcomes. However, it is unclear how well these conditions are addressed in TB policies and healthcare practices.

Between August and October 2021, an online survey was conducted across high-TB burden countries, targeting TB healthcare workers, policymakers, and advocates. Out of 1100 contacted individuals in 33 countries, 446 respondents from 27 countries provided sufficient data.

Key Findings:
Common Comorbidities: HIV, diabetes, depression, and substance use disorders were the most frequently reported.

Screening & Management:

HIV was widely screened for and managed.

Diabetes, tobacco, and alcohol use disorders were screened in about half of TB services, but treatment was limited.

Depression was rarely screened, rarely treated, and only occasionally referred for specialist care.

Healthcare Worker Confidence: Respondents felt comfortable screening for comorbid conditions but lacked confidence in managing them.

Conclusion:
Except for HIV, chronic comorbid conditions are overlooked mainly in TB care. Mental health, in particular, is neglected, despite its impact on TB outcomes. Integrating screening and treatment of these conditions within TB programmes could help improve TB treatment success, address non-communicable diseases (NCDs), and enhance overall patient well-being.