Double Burden Of Disease Research Articles

Implementing a package of essential non-communicable diseases interventions in low- and middle-income countries: a realist review protocol

IntroductionThe burden of non-communicable diseases (NCDs) is increasing rapidly, particularly in low- and middle-income countries (LMIC), accounting for 85% of premature deaths in the region. LMICs have been facing an...

The priority areas and possible pathways for health cooperation in BRICS countries

As one of the largest alliances of middle-income countries, the BRICS, known as an acronym for five countries including “Brazil, Russia, India, China, and South Africa”, represents half of the global population. The health cooperation among BRICS countries will benefit their populations and other middle- and low-income countries. This study aims to summarize the current status of health cooperation in BRICS countries and identify opportunities to strengthen BRICS participation in global health governance. A literature review was conducted to analyze the status, progress, and challenges of BRICS' health cooperation. Content analysis was used to review the 2011–2021 annual joint declarations of the BRICS Health Ministers Meetings. The priority health areas were identified through segmental frequency analysis. Our research suggested that communicable diseases, access to medicine, and universal health coverage appeared most frequently in the content of declarations, indicating the possible top health priorities among BRICS' health collaboration. These priority areas align with the primary health challenges of each country, including the threats of double burden of diseases, as well as the need for improving health systems and access to medicines. Respective external cooperation, inter-BRICS health cooperation, and unified external cooperation are the main forms of health cooperation among BRICS countries. However, challenges such as the lack of a unified image and precise position, lack of practical impact, and weak discourse power have impeded the impact of BRICS on health governance. This study suggests that the BRICS countries should recognize their positioning, improve their unified image, and establish cooperative entities; at the same time, they should increase their practical strength, promote non-governmental cooperation, and expand the cooperation space through the “BRICS Plus” mechanism with countries with similar interests to join.

Social Protection Supports and Management of Non-Communicable Diseases in Ghana: A Qualitative Cross-Sectional Perspective of Health Stakeholders

Introduction: Africa faces a double burden of communicable and non-communicable diseases (NCDs). Already, health systems in Africa are overwhelmed with a high burden of communicable diseases with perennial outbreaks of highly infectious diseases. The rise in NCDs comprises an already fragile health system challenging its ability to provide comprehensive care to people living with these diseases. Without responsive social support systems, NCDs will draw more people into catastrophic health financing, worsening health outcomes, and poverty. This study explores how vulnerable people negotiate major disease burdens with the social protection supports available in Ghana. Methods: The study applied a cross-sectional design with a qualitative approach involving healthcare professionals and non-healthcare professionals in 4 regions in Ghana with a total of 32 qualitative interviews analyzed thematically. Results: The main social protection support for the health sector in Ghana is the National Health Insurance Scheme. Other social protection supports such as free maternal healthcare, Livelihood Empowerment Against Poverty, and conventional informal social protection mechanisms do not directly target people afflicted with NCDs. Even though national health insurance covers about 90% of diseases, the quality of care is questionable. Again, the exclusion of diagnostic investigations makes national health insurance a setback to NCD disease management. Also, NCD patients still do out-of-pocket expenses though they have valid national health insurance. Informal social protection supports which used to be effective sometime back are dwindling due to the rising cost of living, gradual breakdown of the African system of reciprocity, and infiltration of Western lifestyles. Conclusion: NCD patients have very limited social protection for the management of their condition. Health insurance which is the only option for many has limited applications. A multidisciplinary body is established by the government to outline more effective ways of offering social protection support for health services, especially chronic conditions such as NCDs which affect a greater proportion of the population.

Some Elements in The Fruit: An Assessment of Gingerbread Plum from Sokoto, Nigeria

A region like Sokoto that is been challenged by series of problems such as double burden of diseases, malnutrition, and food insecurity should utilized the available fruits for their inherent nutrient’s compositions. Therefore, the objective of this study was to assess the proximate and elemental contents (sodium, phosphorus, potassium, calcium, and magnesium) in gingerbread plum (Neocarya macrophylla) fruit which are essential for normal growth and development of body tissues for the human health. Neocarya macrophylla fruit is screened for certain nutritionally needed elements and proximate compositions using standard methods. Results obtained show that, crude protein with (2.70 ± 0.0057%) has the lowest concentration, the moisture content was 5.83 ± 0.57 percent, ash content was 5.33 ± 1.54 percent, crude lipid was 5.23 ± 0.15 percent, and crude fiber was 13.33 ± 4.48 percent. The determined levels of mineral elements (calcium, magnesium, phosphorus, sodium, and potassium) reveal 30.25000 ppm, 4.9001 ppm, 90. 1000 ppm, 40.563 ppm, and 67.5601 ppm, respectively. Therefore, the plant is nutritious and vital for metabolic processes.

Nasyiyatul Aisyiyah Empowerment as a Motor for Community Care for Non-Communicable Diseases in Adolescents at Patukan Mosque

Indonesia is currently facing a double burden of disease, namely communicable diseases and non-communicable diseases. Non-communicable diseases (NCDs) are diseases that are not caused by bacterial infections, including chronic degenerative diseases such as heart disease, diabetes mellitus (DM), cancer, chronic obstructive pulmonary disease (COPD), disorders due to accidents and acts of violence which are the highest causes of death in Indonesia, and increase in recent years. Initially, these diseases primarily affect the elderly due to degeneration, but in reality, they also affect young people. Therefore, increasing awareness to check their health in younger generation is very important. The purpose of this service is to increase the knowledge and skills of adolescents regarding their own health, especially in preventing NCDs in adolescents. The method used was lectures and practice to members of the Nasyiatul Aisyiyah (NA) and Youth of the Al Ikhsan Patukan mosque. The result of this activity was an increase in participants’ knowledge of NCDs. The training activities were enthusiastically followed by the practice of checking blood pressure and reading HB levels. This activity was followed by youth health check-ups at the Patukan mosque. In conclusion, this activity went smoothly and was completed. NA runs monthly health check-ups from mosque to mosque as a monthly agenda.

Factors Associated with Hypertension Control Behavior in the Pre-Elderly Group in Padangsidimpuan City

<div><table cellspacing="0" cellpadding="0" align="left"><tbody><tr><td align="left" valign="top"><p><em>Indonesia is currently facing a double burden of disease, namely communicable diseases and non-communicable diseases, where behavior is one of the causes of changes in the pattern of these diseases. One of the non-communicable diseases which is the main cause of premature death in the world, namely hypertension is a silent killer with the highest prevalence rate in Indonesia. Untreated hypertension can cause complications. The elderly population is the most vulnerable population suffering from hypertension. One of the areas in North Sumatra with an ever-increasing number of cases of hypertension is Padangsidimpuan City. This study aims to analyze factors related to hypertension control behavior in the pre-elderly group in Padangsidimpuan City. This type of research is quantitative analytic with cross sectional design. The total population in this study was 3104 with a total sample of 237 obtained using cluster sampling and proportional random sampling. The instrument in this study used a questionnaire. The data obtained were analyzed by univariate, bivariate, and multivariate using multiple logistic regression tests. The results showed that there was a relationship between intention (p=0.002), knowledge (p=<0.001), attitude (p=<0.001), affordability of information (p=<0.001), availability of facilities and infrastructure (p=0.020), and support social status (p=0.002) with hypertension control behavior. Multivariate analysis shows that the attitude variable is the variable most related to the behavior of the elderly in controlling hypertension with a Prevalence Ratio (RP) value of 4.869. The pre-elderly group is expected to be more active in adopting a healthy lifestyle, and an active role from the family and health workers is needed in providing support to hypertension sufferers to implement hypertension control behavior and avoid complications.</em></p><p><em> </em></p></td></tr></tbody></table></div><strong><em>Keywords: Behavior, Hypertension Control, Pre-Elderly</em></strong>

METABOLIC SYNDROME IN PATIENTS OF CHRONIC KIDNEY DISEASE PRESENTING TO THE NEPHROLOGY DEPARTMENT OF A TERTIARY CARE HOSPITAL

BACKGROUND AND OBJECTIVE: The prevalence of metabolic syndrome (MetS) is on rise and is proven to be a known factor for cardiovascular diseases. However, its association with chronic kidney disease is also emerging which can accentuate the risk of cardiovascular events in patients of CKD. Therefore, this study was conducted to determine the frequency of metabolic syndrome and its related factors among patients with chronic kidney disease presenting to the Nephrology outdoor.
 MATERIAL AND METHODS: it was a cross sectional study conducted at Nephrology department Jinnah hospital Lahore. About 110 patients of CKD diagnosed for atleast 6 months, aged 18-60 and fulfilling the selection criteria were enrolled after an informed consent by non-probability consecutive sampling. Measurement of blood pressure and central obesity was done as per standard protocol and all the information was recorded in proforma. A 5 ml of blood sample was taken for triglyceride, HDL, and fasting blood sugar levels after ensuring overnight fasting. Frequency percentages were calculated for qualitative variables by using SPSS26. Chi-square test was applied to check statistical significance between metabolic syndrome and effect modifiers.
 RESULTS: The Mean age of patients was 42.46 + 5.580 with about 63(57%) being male. Majority had CKD stage-V 64(58%), and had the disease for more than 5 years i.e. 75(68%). The frequency of MetS was 39(35%) with that of high blood pressure 68(62%) being the most common among all components, followed by high fasting plasma glucose levels 52(47%), high triglyceride levels 35(32%), high HDL levels 32(29%) and central obesity 30(27%). A statistically insignificant relationship of MetS was seen on stratification for age, gender, duration, and stage of CKD.
 CONCLUSION: It can be concluded that a considerable frequency of MetS 35% is present among patients with CKD. Thus, there is a dire need to screen all the patients with CKD for the presence of MetS as an essential component of their routine follow up. This will help in its early diagnosis and management which may halt the disease progression and decrease the morbidity and mortality associated with this lethal but manageable double burden of disease.

Healthcare Services Utilisation and Financial Burden among Vietnamese Older People and Their Households

Background: This research examined differences in the utilisation of healthcare services and financial burden between and within insured and uninsured older persons and their households under the social health insurance scheme in Vietnam. Methods: We used nationally representative data from the Vietnam Household Living Standard Survey (VHLSS) conducted in 2014. We applied the World Health Organization (WHO)’s financial indicators in healthcare to provide cross-tabulations and comparisons for insured and uninsured older persons along with their individual and household characteristics (such as age groups, gender, ethnicity, per-capita household expenditure quintiles, and place of residence). Results: We found that social health insurance was beneficial to the insured in comparison with the uninsured in terms of utilization of healthcare services and financial burden. However, between and within these two groups, more vulnerable groups (i.e., ethnic minorities and rural persons) had lower utilization rates and higher rates of catastrophic spending than the better groups (i.e., Kinh and urban persons). Conclusion: Given the rapidly ageing population under low middle-income status and the “double burden of diseases”, this paper suggested that Vietnam reform the healthcare system and social health insurance so as to provide more equitable utilisation and financial protection to all older persons, including improving the quality of healthcare at the grassroots level and reducing the burden on the provincial/central health level; improving human resources for the grassroots healthcare facilities; encroaching public–private partnerships (PPPs) in the healthcare service provision; and developing a nationwide family doctor network.

Public Health Activities: Evaluation of Community Pharmacists’ Attitude, Practice and Barriers in a Nigerian Southwestern State

The Nigerian health system continues to face double burden of communicable and noncommunicable diseases. To meet the country’s health needs, the number of healthcare professionals participating in public health activities must be increased. The purpose of this study was to assess the attitudes, practices and barriers to rendering public health services among community pharmacists in a southwestern Nigerian state. We used a pretested self-administered questionnaire to collect data on 120 community pharmacists’ sociodemographic characteristics, practices, attitudes and barriers to providing public health services. Participating pharmacists must have at least one year of experience working in a community pharmacy. Data were summarised descriptively using IBM SPSS (version 23.0). Females’ respondents were (n = 69, 57.5%) and (n = 82, 68.3%) pharmacists had 1 year– 5 years’ experience. Most (n = 116, 96.7%) of the respondents agreed that pharmacists should be involved in public health activities, and (n = 106, 88.3%) respondents disagreed that public health activities should be carried out only by doctors and nurses. Overall (n = 89, 74.0%) of the respondents had positive attitude to public health activities (score ≥ 80%) and majority of the community pharmacists had been practicing public health activities. Insufficient time (n = 65, 54.2%) and lack of financial capital to implement changes (n = 84, 70.0%) were identified as prominent barriers that hindered community pharmacists from rendering public health services. Community pharmacists had positive attitude towards the practice of public health activities. However, further studies should emphasise on how to overcome barriers preventing their involvement in public health activities. Providing incentives for public health services rendered could increase community pharmacists’ involvement in public health activities.

Influences of Age, Sex and Raised Body Mass Index on Cardiovascular Disease Risk Factors Among Tribal Adults of India

Introduction. Rapid life style changes are leading causes of increased cardiovascular disease (CVD) risks among people in India today. Despite the country’s high ethnic diversity, studies related to physiology and such health risks, particularly among the tribal populations have been limited. Materials and methods. The present cross-sectional study was conducted among 1,434 tribal participants belonging to six tribes from the two states of West Bengal and Odisha. The aim of the present study was to understand the relationship of age (in years), sex and raised Body Mass Index (BMI) (kg/m2) with selected CVD risk factors among the six tribes of India. Results. In the males, raised BMI (kg/m2) was found to influence CVD risks by significantly increasing the blood glucose among the age group (in years) of <40 years (Odds Ratio (OR)= 6.396, p≤ 0.05); isolated systolic hypertension among the age groups <40 years (OR= 2.387, p≤ 0.01) and ≥40 years (OR= 2.123, p≤ 0.05); isolated diastolic hypertension among the age groups <40 years (OR=4.74, p≤0.001) and >40 years (OR= 3.24, p≤ 0.001); hypertensive MAP among the age group <40 years (OR= 5.769, p≤ 0.001) and hypertensive blood pressure among the age groups <40 years (OR= 5.865, p≤ 0.01) and ≥40 years (OR= 3.127, p≤ 0.01). Conclusion. Among females low BMI (kg/m2) was seen to be linked with higher CVD risk. Influence of BMI (kg/m2), age (in years) and sex on CVD risks can explain the increasing health threat among the tribal populations in India. Mean Arterial Pressure (MAP) can be considered to correctly indicate the cardiovascular risks; particularly in case of the younger population. An increasing tendency towards a double burden of disease is evident in the studied populations. @ 2023. This work is licensed under a CC BY 4.0 license.

Assessing the Interlinkage between Biodiversity and Diet through the Mediterranean Diet Case.

The adoption of healthy and sustainable diets and the transition to sustainable food systems is of principal importance in order to counteract the double burden of climate change and noncommunicable diseases. The Mediterranean diet (MD) has been widely recognized as a biodiversity and healthy nutrition resource to support sustainable development and food security. This study explored biodiversity in terms of food plants species, subspecies, varieties, and races, and also addressed food plant diversity differences between the MD and Western-type consumption patterns. It was funded by the EU BioValue Project, aiming to promote the integration of underutilized crops into the food value chains. Using a 2-stage scheme, data were selected from MEDUSA and Euro+Med databases (including 449 species, 2366 subspecies, varieties, and races). Furthermore, 12 countries from North Africa and Europe were classified in 2 groups according to their subregional attributes and their traditionally most prevalent dietary pattern (MD or Western-type diets). Statistical analysis showed that the mean of the majorly cultivated food plants in the MD was significantly higher than its counterpart in the Western diet. Furthermore, no statistical difference was detected in the averages of native food plants between the MD group and the Western diet group, implying that the higher diversity in food plants observed in the MD seems to be attributed to crop utilization rather than crop availability. Our findings indicated the interlinkage between biodiversity and prevailing dietary patterns and further underlined that biodiversity could constitute a prerequisite for dietary diversity and hence nutrition security. In addition, this study demonstrated that diets and nutrition should be approached in a broader way within the context of both agro-food and ecological systems.

Assessment of Prevalence of Communicable and Non-Communicable Diseases in a Rural Community and its neighborhood in Enugu State, Nigeria: A Cross-Sectional Epidemiological Survey from a Health Outreach

Background: Africa faces a double burden of communicable and chronic non-communicable diseases which have longterm public health impact. This study is to ascertain the disease prevalence, the degree, and the predisposing risk factors of communicable and non-communicable disease in Uvuru, in Uzo-Uwani Enugu State. Materials and Methods: This is a descriptive cross-sectional survey using convenience sampling technique conducted on residents in Uvuru Agada community in Uzo-Uwani Local Government Area of Enugu State using a two-part pro forma. The data was analysed using the Statistical Product and Service Solution (SPSS version 23.0) and results were presented as frequencies and percentages. Chi-square and Pearson correlation coefficient were used to determine statistical relationship existing among variables. Significance difference was accepted at 95% precision (P < 0.05). Results: Majority 495(70.7 %) of the respondents were females while 656 (93.7 %) were adults (> 19 years). Higher percentage 429(61.3 %) had a normal body mass index (BMI). Very few 8 (1.1 %) had respiratory diseases while 469(67.0 %) had malaria. Majority 682(97.4%) of the respondents had at least one non-communicable disease while only 91(13.0%) had at least one non-communicable disease. Conclusion: The prevalence of non- communicable diseases is high. Age, Gender and BMI are risk factors.

Applying the syndemic framework to cancer research for effective cancer control in low- and middle-income countries.

Cancer burden is increasing rapidly globally, especially in low- and middle-income countries (LMICs), which already face a double burden of infectious diseases and other non-communicable diseases (NCDs). LMICs also struggle with poor social determinants of health, leading to cancer health disparities, such as delayed diagnoses and increased death rates due to cancer. Contextually, relevant research needs to be prioritised in these regions to ensure feasible, evidence-based healthcare planning and delivery for cancer prevention and control. A syndemic framework has been used to study the disease clustering of infectious diseases and NCDs across varied social contexts to understand how diseases interact adversely and how the wider environmental context and other socioeconomic factors contribute to poor health outcomes within specific populations. We propose using this model to study the 'syndemic of cancers' in the disadvantaged population of LMICs and suggest ways for the clear operationalisation of the syndemic framework through multidisciplinary evidence-generation models for the delivery of integrated, socially conscious interventions for effective cancer control.

Socio-economic inequalities in burden of communicable and non-communicable diseases among older adults in India: Evidence from Longitudinal Ageing Study in India, 2017-18.

Developing countries like India grapple with significant challenges due to the double burden of communicable and non-communicable disease in older adults. Examining the distribution of the burden of different communicable and non-communicable diseases among older adults can present proper evidence to policymakers to deal with health inequality. The present study aimed to determine socioeconomic inequality in the burden of communicable and noncommunicable diseases among older adults in India. This study used Longitudinal Ageing study in India (LASI), Wave 1, conducted during 2017-2018. Descriptive statistics along with bivariate analysis was used in the present study to reveal the initial results. Binary logistic regression analysis was used to estimate the association between the outcome variables (communicable and non-communicable disease) and the chosen set of separate explanatory variables. For measurement of socioeconomic inequality, concentration curve and concentration index along with state wise poor-rich ratio was calculated. Additionally, Wagstaff's decomposition of the concentration index approach was used to reveal the contribution of each explanatory variable to the measured health inequality (Communicable and non- communicable disease). The study finds the prevalence of communicable and non-communicable disease among older adults were 24.9% and 45.5% respectively. The prevalence of communicable disease was concentrated among the poor whereas the prevalence of NCDs was concentrated among the rich older adults, but the degree of inequality is greater in case of NCD. The CI for NCD is 0.094 whereas the CI for communicable disease is -0.043. Economic status, rural residence are common factors contributing inequality in both diseases; whereas BMI and living environment (house type, drinking water source and toilet facilities) have unique contribution in explaining inequality in NCD and communicable diseases respectively. This study significantly contributes in identifying the dichotomous concentration of disease prevalence and contributing socio- economic factors in the inequalities.

Is Nigeria on course to achieve universal health coverage in the context of its epidemiological and financing transition? A knowledge, capacity and policy gap analysis (a qualitative study)

ObjectivesThis study aimed to assess Nigeria’s preparedness to finance and drive the universal health coverage (UHC) agenda within the context of changing health conditions and resource needs associated with the...

Epidemiologic transition and the double burden of disease in Ghana: What do we know at the neighborhood level?

Many developing countries including Ghana are currently experiencing dual disease burdens emerging from an unprecedented risk overlap that drive their epidemiological transitions. Yet, siloed and disintegrated approaches continue to take precedence in health research and policy programs that drive competition for limited resources to address competing health problems. The objective of this study was to offer empirical evidence in support of a cogent argument for an integrated framework for the study and management of infectious and chronic health conditions in Ghana. We did so by examining the prevalence, determinants, and neighborhoods trajectories of the double burden of disease using data from a cross-sectional neighborhood-based study in Ghana. We fitted multinomial multilevel multivariate models to a sample of 1377 individual surveys and the results presented as odds ratios. Findings show that amidst a rising burden of NCDs, infectious diseases remain the most common health condition and participants in deprived neighborhoods were significantly more likely to report poor health outcomes. Risk factors such as tobacco and alcohol consumption were significantly associated with NCDs and infectious diseases and respondents who reported being diagnosed with NCDs and infectious diseases in the past year were likely to engage in leisure time physical activities and eat healthy. Based on our findings, we recommend health reforms in Ghana and argue for the design and implementation of an integrated framework for the study and management of the double burden of disease in Ghana and similar developing country settings.

Association between multiple chronic conditions and insufficient health literacy: cross-sectional evidence from a population-based sample of older adults living in Switzerland

BackgroundHealth literacy is the ability to find, understand, assess, and apply health information. Individuals suffering from multiple chronic conditions have complex healthcare needs that may challenge their health literacy skills. This study aimed to investigate the relationship between multimorbidity, the number of chronic conditions, and health literacy levels in a sample of adults aged 58+ in Switzerland.MethodsWe used data from 1,615 respondents to a paper-and-pencil questionnaire administered as part of wave 8 (2019/2020) of the Survey of Health, Ageing and Retirement in Europe (SHARE) in Switzerland. Health literacy was measured using the short version of the European Health Literacy Survey questionnaire. The final score ranged from 0 to 16 and was categorised into three health literacy levels: inadequate (0–8), problematic (9–12), and sufficient (13–16). The number of chronic conditions was self-reported based on a pre-defined list. Associations were examined using multivariable ordinary least squares and ordered probit regression models, controlling for key socio-demographic characteristics.ResultsOverall, 63.5% of respondents reported having at least one chronic condition. Respondents who reported one, two, and three or more chronic conditions were more likely to have lower health literacy scores compared to respondents who did not report any chronic condition (p<0.05, p<0.01, and p<0.001, respectively). Suffering from two and three or more chronic conditions (vs. no chronic condition) was significantly associated with a higher likelihood of having inadequate or problematic health literacy levels (both p-values <0.01).ConclusionsOur findings suggest a need to improve health literacy in older adults suffering from chronic conditions. Improved health literacy could constitute a promising lever to empower individuals to better self-manage their health to ultimately reduce the double burden of chronic diseases and insufficient health literacy in this vulnerable population.

Diabetes mellitus and TB - finding strategies to reduce the double burden of disease.

Diabetes mellitus and TB - finding strategies to reduce the double burden of disease.

Determinants of Dietary Pattern &amp; Non Communicable Diseases among Adult Population of Districts Kohat &amp; Nowshera KP

Aim: To estimate the burden of non-communicable diseases and to assess the dietary pattern along with important relevant determinants among adult population of district Kohat &amp; Nowshera Khyber Pukhtunkhwa Pakistan Study Design: A descriptive cross sectional study Place &amp; Duration: This study was conducted in Kohat &amp; Nowshera Districts of Khyber Pukhtunkhwa Pakistan; from June to December 2022. Methodology: A total of n=385 male adults was selected and a structured questionnaire was used to collect relevant information regarding demographic, dietary, behavioral determinants. Finally data was analyzed and presented in form of text and tables. Results: Results showed that 55.71% had age above 37 years; 28.31% were illiterate; 25.71% had monthly income more than 45000/ PKR; 60.78% were married; and 82.08% were employed. Moreover, 30.39% were current tobacco smoking; and 24.68% had positive history of past tobacco smoking. Furthermore, 44.94% prefer high caloric; 40.78% vegetables; 45.19% meat; 63,38% fresh fruits; and 18.70% &amp; 21.30% prefer too much sugar and salt in food respectively. Furthermore; hypertension, malnutrition, eye problems and cancer were found among 22.60%, 59.74%, 7.01% &amp; 2.08% respectively. Conclusions: It was concluded that common non-communicable diseases were present in the studied male adults and showed strong relationship with dietary pattern along with demographic, epidemiological and socio-economical determinants. Moreover, effective and efficient policies and strategies were needed to reduce the double burden of non-communicable disease and its associated complications. Keywords: Prevalence, Determinants, Diet, Vegetables, Overweight, Obesity, Tobacco, Adults

Gender differences in tuberculosis patients with comorbidity: A cross-sectional study using national surveillance data and national health insurance claims data in South Korea.

The coexistence of tuberculosis and other chronic diseases complicates disease management. Particularly, the lack of information on the difference in the prevalence of chronic diseases in tuberculosis based on age and gender can hinder the establishment of appropriate public health strategies. This study aimed to identify age- and gender-based differences in the prevalence of chronic diseases as comorbidities in patients with tuberculosis. An anonymized data source was established by linking the national health insurance claims data to the Korean national tuberculosis surveillance data from 2014 to 2018. The prevalence of chronic diseases was stratified by gender and age (age groups: ≤64, 65-74, and ≥75 years), and the differences in the prevalence of chronic diseases were analyzed by multinomial logistic regression and classified using the Charlson Comorbidity Index. A total of 148,055 patients with tuberculosis (61,199 women and 86,856 men) were included in this study. Among the patients aged ≥65 years, 48.2% were female and 38.1% were male. In this age group, the probability of chronic disease comorbidity was higher in female patients than in male patients. The prevalence of congestive heart failure and dementia as comorbidities in patients with tuberculosis increased more drastically with age in women than in men. Thus, the present study confirmed gender and age differences in the distribution of comorbidities among patients with tuberculosis. A more comprehensive gender-responsive approach for patients with tuberculosis and chronic diseases is required to alleviate the double burden of infectious diseases and non-communicable diseases in an aging society.