Co-morbid conditions associated with tuberculosis (TB): Results from a 1-day, point-prevalence study in 204,912 physician diagnosed patients from 880 cities and towns in India

Abstract

Introduction: Tuberculosis is known to be associated with several co-morbid conditions such as human immunodeficiency virus (HIV) infections, diabetes and obstructive airway diseases (OADs). Aim: We aimed to study the association between physician diagnosed TB and co-morbid conditions in a large cross-sectional cohort in India. Methodology: 13,225 general practitioners, general physicians and pediatricians from 880 cities and towns were randomly selected and invited to participate in a 1-day point-prevalence study. On the study day all participating doctors captured details of age, gender, presenting symptoms and diagnosis of all patients who visited them. Clean data was transferred into the Epi Info software and associations between Tuberculosis and other co-morbid conditions were analyzed using chi-square test. Results: 7,400 doctors consented and provided clean data of 204,912 patients (M:54%; F:46%). Out of these, 3719 (1.8%) patients were reported to have TB (M:F 59.8%:40.2%, mean age: 35.7 ± 19.7 yrs). Patients diagnosed with TB showed a strong association with anemia [OR: 2.2 (1.9, 2.4); p<0.0001] congestive heart failure (CHF) [OR:1.8 (1.3, 2.4); p<0.0001], OADs [OR: 1.5 (1.4, 1.7); p<0.0001], ischemic heart disease (IHD) [OR: 1.4 (1.1, 1.8); p<0.005], and thyroid disorders [OR:1.4 (1.1, 1.9); p<0.007]. Conclusion: In this Indian cross sectional study, tuberculosis was strongly associated with the presence of anemia, CHF, OADs, IHD and thyroid disorders.