Evidence map›Paper›PMID 40365030›Full record

ArticleIJTLD open2025

TB disability and multimorbidity at the onset of treatment in Kenya, Uganda, Zambia and Zimbabwe.

Kenya, Uganda, Zambia and Zimbabwe TB Disability Study Group listed by surname alphabetically:, S A Adakun, F M Banda, A Bloom, M Bochnowicz, J Chakaya, R Chimzizi, J P Dongo, C Duri, A D Harries and 19 more

Abstract read
In one paragraph

Article in IJTLD open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Kenya, Uganda, Zambia and Zimbabwe TB Disability Study Group listed by surname alphabetically:
S A AdakunMulago National Referral Hospital, Kampala, Uganda.
F M BandaUniversity Teaching Hospital, Ministry of Health, Lusaka, Zambia.
A BloomFree Lance, Public Health Specialist, Washington D.C, USA.
M BochnowiczFree Lance, Public Health Specialist, Washington D.C, USA.
J ChakayaDepartment of Medicine, Therapeutics, Dermatology and Psychiatry, Kenyatta University, Nairobi, Kenya.
R ChimziziMinistry of Health, Long-term Exceptional Technical Assistance Project, Genesis, Lusaka, Zambia.
J P DongoInternational Union Against Tuberculosis and Lung Disease-Uganda Office, Kampala, Uganda.
C DuriDirectorate of Health Services, Harare City Council, Harare, Zimbabwe.
A D HarriesInternational Union Against Tuberculosis and Lung Disease, Paris, France.
I KathureDivision of National TB, Leprosy and Lung Disease Programme, Ministry of Health, Nairobi, Kenya.
F N KavengaMinistry of Health and Child Care, AIDS and TB Department, Harare, Zimbabwe.
A M V KumarInternational Union Against Tuberculosis and Lung Disease, Paris, France.
Y LinInternational Union Against Tuberculosis and Lung Disease, Paris, France.
H LuzzeNational Tuberculosis and Leprosy Programme, Ministry of Health, Kampala, Uganda.
I MbithiRespiratory Society of Kenya, Nairobi, Kenya.
M MputuNational Tuberculosis and Leprosy Programme, Ministry of Health, Lusaka, Zambia.
A MubangaNational Tuberculosis and Leprosy Programme, Ministry of Health, Lusaka, Zambia.
D MudoolaInternational Union Against Tuberculosis and Lung Disease-Uganda Office, Kampala, Uganda.
D NairFree Lance, Public Health Specialist, New Delhi, India.
M NgwenyaMinistry of Health and Child Care, AIDS and TB Department, Harare, Zimbabwe.
S NtambiMulago National Referral Hospital, Kampala, Uganda.
P OwitiDivision of National TB, Leprosy and Lung Disease Programme, Ministry of Health, Nairobi, Kenya.
A OwuorKenyatta National Hospital, Nairobi, Kenya.
P ThekkurInternational Union Against Tuberculosis and Lung Disease, Paris, France.
C TimireInternational Union Against Tuberculosis and Lung Disease, Paris, France.
E TweyongyereNational Tuberculosis and Leprosy Programme, Ministry of Health, Kampala, Uganda.
M YaDiulFree Lance, Public Health Specialist, Washington D.C, USA.
R ZachariahUNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), World Health Organization, Geneva, Switzerland.

Funding

World Health Organization 001
6 · The paper itself

Abstract

backgroundWe evaluated the practicality of integrating assessments on the burden of multimorbidity (including disability) and the effectiveness of referral pathways at the start of TB treatment across Kenya, Uganda, Zambia and Zimbabwe.

methodsA cohort study conducted within national TB programmes.

resultsAssessments were conducted in 1,683 (92%) of 1,822 patients, taking a median time of 29 minutes (interquartile range:20-37). Regarding comorbidities, 567 (34%) had HIV infection, 141 (8%) had high-blood pressure, 101 (6%) had a mental health disorder and 65 (4%) had diabetes. The three most common risk factors were undernutrition in 622 (37%), probable alcohol dependence in 311 (18%) and cigarette smoking in 275 (16%). Disability (inability to walk 400m in six minutes) was observed in 316 of 1,545 (20%) patients. Overall, 1,305 (78%) patients had at least one comorbidity, risk factor and/or disability. Successful referral ranged from 85-100% for most conditions, except for those with occupational silica exposure and disability, where access to pulmonary rehabilitation services was suboptimal.

conclusionsA significant proportion of TB patients experienced multimorbidity, including disability, highlighting the need for integrated, patient-centered care and decentralized point-of-care services, particularly for pulmonary rehabilitation. This multi-country study offers a promising pathway towards achieving that goal.

Indexed as

real-time operational researchSORT ITsub-Saharan Africatuberculosisuniversal health coverage

Identifiers

PMID40365030
PMCPMC12068455

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.