Non-communicable disease co-morbidity and associated factors in tuberculosis patients: A cross-sectional study in Gabon

Background There are only limited data from resource-limited settings available on the prevalence of non-communicable diseases and associated risk factors of tuberculosis patients. This study investigated non-communicable disease co-morbidity in tuberculosis patients from Moyen Ogooue Province, Gabon. Methods All patients aged 18 years or older consulting for tuberculosis (TB) symptoms in Gabon's Moyen Ogooue province and neighbouring provinces from November 2018 to November 2020 were screened for diabetes mellitus, hypertension, and risk factors thereof (obesity, dyslipidaemia, smoking and alcohol consumption). Logistic regression was performed to identify factors associated with TB-diabetes and TB-hypertension co-morbidities. Findings Of 583 patients included, 227 (39%) were diagnosed with tuberculosis. In tuberculosis-confirmed patients, the prevalences of hypertension and diabetes were 16 center dot 3% and 12 center dot 8%, respectively. The prevalence of diabetes was twice as high in tuberculosis patients compared to non-tuberculosis patients. Factors independently associated with hypertension-tuberculosis co-morbidity were age > 55 years (aOR=8 center dot 5, 95% CI 2 center dot 43, 32 center dot 6), age 45- 54 years (aOR=4.9, 95%CI 1.3- 19.8), and moderate alcohol consumption (aOR=2 center dot 4; 95% CI 1 center dot 02- 5 center dot 9), respectively. For diabetes-tuberculosis co-morbidity, age > 55 years was positively (aOR=9 center dot 13; 95% CI 2 center dot 4-39 center dot 15), and moderate alcohol consumption inversely associated (aOR=0 center dot 26, 95% CI 0 center dot 08- 0 center dot 73). One-hundred-and-four (46%) of the tuberculosis patients had at least either dyslipidaemia, hypertension, diabetes, or obesity with a majority of newly-diagnosed hypertension and diabetes. Interpretation Integration of screening of non-communicable diseases and their risk factors during TB assessment for early diagnosis, treatment initiation and chronic care management for better health outcomes should be implemented in all tuberculosis healthcare facilities. Copyright (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)