Non-communicable diseases in TB household contacts

A cross-sectional study conducted in Yangon, Myanmar, from April to December 2018 explored demographic, behavioral, and health characteristics of TB patients, their household contacts, and the general population. Most household contacts were female (68.9%), while TB patients were predominantly male (66.1%). Age distribution was similar across groups, though TB patients had fewer individuals over 65 years. Behavioral risk factors were more pronounced in TB patients, who had 2.5 times and 4.6 times higher odds of smoking and drinking, respectively, compared to the general population. Household contacts also showed increased odds for these behaviors (1.7 and 2.1 times, respectively).[1]

Nutritional and metabolic disparities were significant. TB patients were seven times more likely to be underweight and had markedly lower probabilities of being overweight or obese (62% and 92% lower, respectively). They also exhibited a 6.3 times higher likelihood of diabetes mellitus (DM), with odds reducing to 3.4 when BMI-mediated pathways were considered. Conversely, TB patients and their household contacts had lower odds of hypertension, with TB patients showing up to 71% lower odds when BMI pathways were accounted for. These findings emphasize the health and behavioral differences between TB patients, their household contacts, and the general population.[1]

Integrating non-communicable disease (NCD) screening, care, and prevention into TB contact tracing offers an efficient way to maximize resources and improve cost-effectiveness. Household contacts (HHCs) of TB patients often share risk factors that make them more susceptible to NCDs, such as diabetes mellitus (DM), compared to the general population. Incorporating NCD screening during TB contact investigations enables the identification of individuals who may be unaware of their conditions, allowing for timely intervention and management. Early detection and treatment of DM among TB contacts could also help reduce the incidence of TB.[2]

The high prevalence of NCDs observed among HHCs and even among neighborhood controls underscores the necessity for community-wide screening initiatives. Notably, a significant number of undiagnosed NCD cases, particularly DM, were identified among TB contacts and community members, demonstrating the potential of integrating NCD screening into TB contact tracing efforts. This approach not only addresses the dual burden of TB and NCDs but also provides an opportunity to improve health outcomes across the broader community.[2]

References:

[1] Zayar, N.N., Chotipanvithayakul, R., Bjertness, E., Htet, A.S., Geater, A.F. and Chongsuvivatwong, V., 2023. Vulnerability of NCDs and Mediating Effect of Risk Behaviors Among Tuberculosis Patients and Their Household Contacts Compared to the General Population in the Yangon Region, Myanmar. International Journal of General Medicine, pp.5909-5920.

[2] Hamada, Y., Lugendo, A., Ntshiqa, T., Kubeka, G., Lalashowi, J.M., Mwastaula, S., Ntshamane, K., Sabi, I., Wilson, S., Copas, A. and Velen, K., 2024. A pilot cross-sectional study of non-communicable diseases in TB household contacts. IJTLD OPEN, 1(4), pp.154-159.