Multimorbidity in people with tuberculosis

Abstract

Each year, tuberculosis (TB) affects 10 million people -mostly the poor. Multimorbidity, the coexistence of two or more disorders, is common in TB and increases TB disease burden. Many non-communicable diseases (NCDs) cluster together with TB due to common risk factors e.g. smoking, poor diet and immunity, drug interactions, and poverty. The most common include diabetes, depression, chronic respiratory disorders, and cardiovascular diseases. Coexisting with TB, these conditions are highly prevalent and commonly cluster together. They are responsible for substantial morbidity, mortality; these conditions adversely interact and worsen TB outcomes, and have common, overlapping, or complementary approaches to management. Care for TB multimorbidity remains neglected in single-disease-focused TB programs in high TB-burden countries such as Pakistan. There is an urgent need for a care package for TB multimorbidity that capitalizes on synergies in the care of common coexisting NCDs. Such an approach may be more effective, efficient, joined-up, and patient-centered than addressing single comorbid conditions separately. More importantly, people with TB multimorbidity do not need to negotiate multiple, disparate care pathways to access care for co-existing conditions.