S81 Chronic diseases and TB risk factors among TB household contacts in Southern Africa

• Published in: Thorax Vol. 77; no. Suppl 1; pp. A50 - A51
• Main Authors: Calderwood, CJ, Marambire, E, Banze, D, Nhamuave, C, Mfinanga, A, Minja, LT, Khosa, C, Mutsvanga, J, Heinrich, N, Kranzer, K
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and British Thoracic Society 11.11.2022; BMJ Publishing Group LTD
• Subjects: Chronic illnesses; Diabetes; Households; Infectious diseases; Lung diseases; Medical screening; Risk factors; Tuberculosis; ‘Die Hard I’ – Resistance, screening and best management in TB; Zimbabwe; Mozambique
• ISSN: 0040-6376; 1468-3296
• DOI: 10.1136/thorax-2022-BTSabstracts.87

BackgroundTB-affected communities are often highly vulnerable, with social, economic and biological factors increasing their risk of both TB and chronic diseases whilst impeding healthcare access. In the context of an urgent need to innovate in and upscale TB screening, and improve diagnosis and „management of non-communicable diseases (NCDs) in Africa, we are evaluating the potential benefits of integrating household contact tracing for TB with screening for other conditions.MethodsEmbedded in a TB household contact screening study (ERASE-TB; Mozambique, Tanzania and Zimbabwe), we are screening for HIV, TB (WHO symptom screen and chest X-„ray), diabetes (HbA1c), hypertension, undernutrition/obesity (body mass index), anaemia and chronic lung disease (spirometry; Global Lung Function Initiative reference standards).ResultsHere we present results for the first 449 TB household contacts (366 in Zimbabwe, 83 in Mozambique). 129 were children/adolescents (age ≥10 years), 320 were adults. 62% were female, 13% had ever smoked and 12% scored positive on alcohol (AUDIT-C) screening. 8% of people were underweight, whilst 39% adults were overweight or obese. TB screening was positive in 21% (of whom 5% Xpert positive). HIV prevalence was 16% (among whom 4% newly diagnosed); diabetes prevalence was 9% (64% newly diagnosed) and 19% of people were anaemic. 24% had elevated blood pressure (a new finding in 56%). 28% had any spirometric abnormality; 7% had obstructive lung disease (all newly diagnosed). 43% of people had at least one condition (13% had multimorbidity), 73% of whom had at least one condition diagnosed by screening.ConclusionOur findings demonstrate the ‘double burden’ caused by the colliding epidemics of infectious diseases and nutritional disorders, with that of NCDs. The vast majority of NCDs were previously undiagnosed (in contrast to HIV where most people knew their status) highlighting the need to strengthen diagnosis and care for NCDs. Integrating TB and chronic disease screening may improve detection of NCDs, promoting overall health and reducing risk of progression to TB disease among exposed household members.Please refer to page A211 for declarations of interest related to this abstract.