Multimorbidity, the co-occurrence of two or more conditions, is a growing concern worldwide. Approximately 30% of adults in developed countries experience multimorbidity (Jarde et al., 2023). The prevalence in low- and middle-income countries (LMICs) is also on the rise and is attributed to factors such as chronic communicable diseases (CCDs) like tuberculosis (TB) and HIV, demographic shifts, urbanization, environmental changes, economic empowerment, and lifestyle alterations (Bush & Gorman, 2018; Cohen-Adad & Wheeler-Kingshott, 2014).
Multimorbidity of TB and chronic conditions like diabetes, depression, and cancer has negative effects on mortality, economic situations, and overall health. The economic impact of TB multimorbidity strains healthcare systems in LMICs, making it difficult to meet public health targets. Existing systematic reviews have focused on individual chronic conditions in individuals with TB, but comprehensive evidence for various other chronic conditions and their associated burden is lacking (Huddart et al., 2020; Gautam et al., 2021).
A recent review by Alexander Jarde and colleagues (2023) examined the prevalence and risk of chronic diseases in individuals with TB in LMICs, comparing them to those without TB. The review explored health outcomes in TB multimorbidity, addressing disease burden and the effectiveness of TB treatment.
Key Findings
The review identified 54 studies covering 6,296,000 individuals with TB in 85 LMICs. The reviews revealed high prevalence of conditions like HIV, diabetes, depression, anxiety, and other chronic diseases in individuals with TB in LMICs. The review suggested that almost half of people with tuberculosis also have depression in LMICs.
The review has implications for practice, policy, and research, and it highlights the urgent need for research to identify at-risk populations, prevent TB multimorbidity, and establish effective treatments and care pathways. It also emphasizes the need for strong healthcare systems in LMICs with sufficient resources for diagnosis, treatment, and follow-up of individuals with TB and other chronic conditions.
Strengths and Limitations
Key strengths of the review include its comprehensive search strategy and emphasis on LMICs, while limitations include high heterogeneity in meta-analyses and low quality of the summarized studies.
Implications
The review has implications for practice, policy, and research and highlights the urgent need for managing multimorbidity, modifying TB treatment based on co-morbidities, and training healthcare workers in LMICs.
