Multimorbidity in tuberculosis (TB) and its impact on patient care (MITICare): a cross-sectional study nested within a prospective cohort study protocol.

Q1 Medicine

Wellcome Open Research Pub Date : 2025-05-28 eCollection Date: 2025-01-01 DOI:10.12688/wellcomeopenres.24237.1

Katherine Hill, Rogers Owori, Molly Naisanga, Noela Owarwo, Sarah Mills, Helen R Stagg, Stellah Mpagama, Christine Sekaggya-Wiltshire, Derek Sloan

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Abstract

Multimorbidity, defined as two or more co-existing long-term health conditions, is increasing in low- and middle-income countries, overlapping with ongoing high tuberculosis (TB) incidence. It is known that there is a high prevalence of multimorbidity in patients with TB in South Africa, but our understanding of how common TB-multimorbidity is in other African countries, and its effect on the trajectories of TB care, is limited. This cross-sectional study nested within a prospective cohort (co-designed between the Infectious Diseases Institute, Uganda and the University of St Andrews, United Kingdom) aims to describe the burden and evaluate the consequences of multimorbidity among patients with TB disease in Kampala, Uganda. The primary objective is to describe the prevalence of multimorbidity at the start of treatment for TB. The secondary objectives are to determine the effect of multimorbidity on clinical characteristics at the start of treatment, progress through TB care, and end of TB treatment outcomes. 254 adults commencing treatment for TB shall be recruited. Multimorbidity shall be assessed using structured questionnaires, simple examination and blood analysis. Th clinical characteristics of TB shall be determined using health and quality of life scores and, in patients with pulmonary TB, the degree of chest X-ray abnormalities and sputum bacillary burden. Patients shall be followed-up at two and six months and their response to treatment determined. The analysis of the prevalence of multimorbidity at baseline shall be reported using a proportion and 95% confidence interval. For the secondary objectives, regression models adjusting for confounders identified through directed acyclic graphs will be used. This study has been developed in close collaboration with a core patient and public involvement group, who will also be actively involved in the dissemination of study results. Ugandan and St Andrews University ethical approval has been prospectively granted (IDI-REC-2023-82, MD17720 and HS3888ES).

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结核病的多发病及其对患者护理的影响（MITICare）：一项嵌套在前瞻性队列研究方案中的横断面研究。

在低收入和中等收入国家，多重发病（定义为两种或两种以上共存的长期健康状况）正在增加，与持续的高结核病发病率重叠。众所周知，南非结核病患者的多重发病率很高，但我们对其他非洲国家结核病多重发病率的普遍程度及其对结核病治疗轨迹的影响的了解有限。这项横贯研究是在一项前瞻性队列研究（由乌干达传染病研究所和英国圣安德鲁斯大学共同设计）中进行的，旨在描述乌干达坎帕拉结核病患者多重发病的负担并评估其后果。主要目的是描述结核治疗开始时多重发病的流行情况。次要目标是确定多重发病对治疗开始时临床特征、结核治疗进展和结核治疗结束结果的影响。将招募254名开始结核病治疗的成年人。采用结构化问卷、简单检查和血液分析对多病进行评估。结核病的临床特征应通过健康和生活质量评分来确定，对于肺结核患者，应通过胸片异常程度和痰杆菌负担来确定。患者应在2个月和6个月随访，并确定其对治疗的反应。基线时多重发病发生率的分析应使用比例和95%置信区间进行报告。对于次要目标，将使用回归模型调整通过有向无环图确定的混杂因素。这项研究是与核心患者和公众参与小组密切合作开展的，他们也将积极参与研究结果的传播。乌干达和圣安德鲁斯大学的伦理批准已获得前瞻性批准（id - rec -2023-82， MD17720和HS3888ES）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Wellcome Open Research Biochemistry, Genetics and Molecular Biology-Biochemistry, Genetics and Molecular Biology (all)

CiteScore

5.50

自引率

0.00%

发文量

426

审稿时长

1 weeks

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