Burden of co-morbid conditions in TB patients attending a tertiary care hospital in India

<b>Background:</b> Tuberculosis(TB) is a debilitating disease with devastating consequences unless detected and treated early. Comorbidities such as Diabetes, HIV, and malnutrition are well established risk factors for the reactivation of TB. However both Pulmonary TB(PTB) and Extrapulmonary TB(EPTB) patients could have several respiratory and non respiratory comorbidities, some of which may contribute to the morbidity and disease outcomes including mortality. These have not been well studied. <b>Methods:</b> This was a retrospective study of newly diagnosed cases of PTB and EPTB presenting to a tertiary care hospital in Southern India, from Jan-Dec 2018. Subjects were included if they had disease either microbiologically confirmed by smear, geneXpert, culture or by histopathology with consistent clinical picture. A detailed review of the hospital records was carried out to identify respiratory co-morbidities such as ILD, Sarcoidosis, COPD, Bronchial asthma, Lung malignancy, and Bronchiectasis. Non-respiratory co-morbidities were classified under: Haematological, Oncological, Cardiovascular(IHD, HTN), Endocrinology &amp; Diabetes, Rheumatologic, Autoimmune and HIV. <b>Results:</b> We included 451 patients with TB, 340-PTB, 82-EPTB and 29 with both. Overall, 371(82.3%) patients had at least one comorbidity; 29% had 1, 25.3% had 2 and 27.9% had 3 or more comorbidities. The most common comorbidities were Anaemia(52.5%), malnutrition(36.4%), DM(34.1%) &amp; HTN(13.7%). The common respiratory comorbidities among PTB were; BA(6.2%), COPD(5%), Bronchiectasis(5.9%) and ILD(2.6%). <b>Conclusion:</b> Substantial number of TB patients in India had comorbidities. This study makes a case for careful screening for comorbidities in TB.