IJTLD Open (May 2024)
Disability, comorbidities and risk determinants at end of TB treatment in Kenya, Uganda, Zambia and Zimbabwe
- The Kenya, Uganda, Zambia, and Zimbabwe TB Disability Study Group (members listed here in alphabetical order):,
- S.A. Adakun,
- F.M. Banda,
- A. Bloom,
- M. Bochnowicz,
- J. Chakaya,
- A. Chansa,
- H. Chiguvare,
- R. Chimzizi,
- C. Colvin,
- J.P. Dongo,
- A. Durena,
- C. Duri,
- R. Edmund,
- A.D. Harries,
- I. Kathure,
- F.N. Kavenga,
- Y. Lin,
- H. Luzze,
- I. Mbithi,
- M. Mputu,
- A. Mubanga,
- D. Nair,
- M. Ngwenya,
- B. Okotu,
- P. Owiti,
- A. Owuor,
- P. Thekkur,
- C. Timire,
- S. Turyahabwe,
- E. Tweyongyere,
- M. YaDiul,
- R. Zachariah,
- K. Zimba
Affiliations
- The Kenya, Uganda, Zambia, and Zimbabwe TB Disability Study Group (members listed here in alphabetical order):
- S.A. Adakun
- Mulago National Referral Hospital, Kampala, Uganda;
- F.M. Banda
- University Teaching Hospital, Ministry of Health, Lusaka, Zambia;
- A. Bloom
- Credence, Contractor for USAID Health Training, Advisory, and Support Contract (GHTASC), Washington DC, USA;
- M. Bochnowicz
- Credence, Contractor for USAID Health Training, Advisory, and Support Contract (GHTASC), Washington DC, USA;
- J. Chakaya
- Department of Medicine, Therapeutics, Dermatology and Psychiatry Kenyatta University, Nairobi,
- A. Chansa
- Ndola Teaching Hospital, Ministry of Health, Ndola, Zambia;
- H. Chiguvare
- United States Agency for International Development (USAID), Harare, Zimbabwe;
- R. Chimzizi
- Ministry of Health, USAID Long-term Exceptional Technical Assistance Project, Genesis, Lusaka, Zambia;
- C. Colvin
- United States Agency for International Development (USAID), Harare, Zimbabwe;
- J.P. Dongo
- International Union Against Tuberculosis and Lung Disease (The Union) Uganda Office, Kampala, Uganda;
- A. Durena
- United States Agency for International Development (USAID), Harare, Zimbabwe;
- C. Duri
- Directorate of Health Services, Harare City Council, Harare, Zimbabwe;
- R. Edmund
- United States Agency for International Development (USAID), Harare, Zimbabwe;
- A.D. Harries
- The Union, Paris, France;
- I. Kathure
- Ministry of Health, Division of National TB, Leprosy and Lung Disease Programme, Nairobi, Kenya;
- F.N. Kavenga
- Ministry of Health and Child Care, AIDS and TB Department, Harare, Zimbabwe;
- Y. Lin
- The Union, Paris, France;
- H. Luzze
- National Tuberculosis and Leprosy Programme, Ministry of Health, Kampala, Uganda;
- I. Mbithi
- Respiratory Society of Kenya, Nairobi, Kenya;
- M. Mputu
- National Tuberculosis Programme, Ministry of Health/USAID TBLON, Lusaka; Zambia;
- A. Mubanga
- National Tuberculosis Programme, Ministry of Health/USAID TBLON, Lusaka; Zambia;
- D. Nair
- The Union, Paris, France;
- M. Ngwenya
- Ministry of Health and Child Care, AIDS and TB Department, Harare, Zimbabwe;
- B. Okotu
- Ministry of Health, Division of National TB, Leprosy and Lung Disease Programme, Nairobi, Kenya;
- P. Owiti
- USAID, Health, Population and Nutrition Office, Kenya and East Africa, Nairobi,
- A. Owuor
- Kenyatta National Hospital, Nairobi, Kenya;
- P. Thekkur
- The Union, Paris, France;
- C. Timire
- The Union, Paris, France;
- S. Turyahabwe
- National Tuberculosis and Leprosy Programme, Ministry of Health, Kampala, Uganda;
- E. Tweyongyere
- National Tuberculosis and Leprosy Programme, Ministry of Health, Kampala, Uganda;
- M. YaDiul
- USAID, Washington DC, USA;
- R. Zachariah
- UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland;
- K. Zimba
- USAID, Lusaka, Zambia
- DOI
- https://doi.org/10.5588/ijtldopen.24.0082
- Journal volume & issue
-
Vol. 1,
no. 5
pp. 197 – 205
Abstract
BACKGROUND: We examined the feasibility of assessing and referring adults successfully completing TB treatment for comorbidities, risk determinants and disability in health facilities in Kenya, Uganda, Zambia and Zimbabwe. METHODS: This was a cross-sectional study within national TB programmes. RESULTS: Health workers assessed 1,063 patients (78% of eligible) in a median of 22 min [IQR 16–35] and found it useful and feasible to accomplish in addition to other responsibilities. For comorbidities, 476 (44%) had HIV co-infection, 172 (16%) had high blood pressure (newly detected in 124), 43 (4%) had mental health disorders (newly detected in 33) and 36 (3%) had diabetes mellitus. The most common risk determinants were ‘probable alcohol dependence’ (15%) and malnutrition (14%). Disability, defined as walking <400 m in 6 min, was found in 151/882 (17%). Overall, 763 (72%) patients had at least one comorbidity, risk determinant and/or disability. At least two-thirds of eligible patients were referred for care, although 80% of those with disability needed referral outside their original health facility. CONCLUSIONS: Seven in 10 patients completing TB treatment had at least one comorbidity, risk determinant and/or disability. This emphasises the need for offering early patient-centred care, including pulmonary rehabilitation, to improve quality of life, reduce TB recurrence and increase long-term survival.
Keywords
- tb-associated disability
- tb-associated lung disease
- real-time operational research
- sort it
- universal health coverage
