Multimorbidity in tuberculosis-affected households: evaluation of disease clustering and the acceptability and yield of integrated health screening in East and Southern Africa (IMBA Hutano)

Tuberculosis-affected communities are often highly vulnerable, with social, economic, and biological factors elevating risk of tuberculosis and chronic diseases whilst limiting healthcare access. Tuberculosis, in other words, has syndemic interactions with chronic diseases (such as HIV, undernutrition and diabetes), behaviours (such as smoking and alcohol use) and social factors (such as poverty and crowding). Progress towards TB elimination has been slow, whilst non-communicable diseases (NCDs) have emerged as a major public health threat in Africa. This project investigated chronic diseases among TB-affected households and provided evidence on integrated tuberculosis screening and care, in Africa and across high-TB burden settings. It combined epidemiology with qualitative methods, drawing on data from a tuberculosis household contact cohort study (ERASE-TB) in Mozambique, Tanzania and Zimbabwe, and a nested implementation study in Zimbabwe. Resources and data relating to the primary analyses of ERASE-TB (evaluation of novel tuberculosis diagnostic tests) are held at LMU Munich (contact: Norbert.Heinrich@med.uni-muenchen.de).