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Aim <p>Patients with tuberculosis (TB), particularly those with multidrug-resistant TB (MDR-TB), face a high multimorbidity burden that complicates treatment and escalates costs. This population-based study aimed to characterize multimorbidity patterns and quantify their health and economic impacts among patients with MDR-TB and non-drug-resistant TB (NDR-TB) in China.</p> Subject and methods <p>We utilized multicenter cross-sectional data from 33,259&#xa0;TB patients (2019–2022, excluding 2020) in Wuhan and Yingtan city, and analyzed multimorbidity prevalence, disease associations via network analysis, and financial burden using generalized linear models (GLMs).</p> Results <p>The study revealed that 16.25% of patients had MDR-TB, with higher multimorbidity burden in older, male, and MDR-TB cohorts. MDR-TB patients exhibited distinct clusters (e.g., anemia exhibited significant multimorbidity with neutropenia [ρ = 0.150, <i>P</i> &lt; 0.001] and hypoproteinemia [ρ = 0.254, <i>P</i> &lt; 0.001]), while NDR-TB patients showed stronger type 2 diabetes mellitus (T2DM)-cardiovascular linkages. Adjusted GLMs demonstrated that MDR-TB status (β = −9.24%, 95% CI [−13.93, −4.40], <i>P</i> &lt; 0.001) decreased the total health expenditure (THE), while multimorbidity count (β = 4.71%, 95% CI [4.19, 5.23], <i>P</i> &lt; 0.001), prolonged hospitalization (β = 6.82%, 95% CI [6.61, 7.04], <i>P</i> &lt; 0.001), Urban and Rural Resident Basic Medical Insurance (URRBMI; β = 36.89%, 95% CI [34.31, 39.51], <i>P</i> &lt; 0.001), and no insurance (β = 164.43%, 95% CI [151.18, 172.10], <i>P</i> &lt; 0.001) independently increased out-of-pocket (OOP) expense.</p> Conclusion <p>Integrated TB-noninfectious chronic disease (NCD) screening, optimized treatment protocols to address drug interactions, and policy reforms should be implemented to address the growing burden of TB multimorbidity in low- and middle-income countries (LMICs).</p>

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Identifying multimorbidity patterns in tuberculosis patients of China: a population-based study

  • 期刊论文

  • 发表日期：

    2026年1月14日

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  • Bingbing Tuo,
  • Kunhe Lin,
  • Anxin Hu,
  • Li Xiang,
  • Junnan Jiang

摘要

Aim

Patients with tuberculosis (TB), particularly those with multidrug-resistant TB (MDR-TB), face a high multimorbidity burden that complicates treatment and escalates costs. This population-based study aimed to characterize multimorbidity patterns and quantify their health and economic impacts among patients with MDR-TB and non-drug-resistant TB (NDR-TB) in China.

Subject and methods

We utilized multicenter cross-sectional data from 33,259 TB patients (2019–2022, excluding 2020) in Wuhan and Yingtan city, and analyzed multimorbidity prevalence, disease associations via network analysis, and financial burden using generalized linear models (GLMs).

Results

The study revealed that 16.25% of patients had MDR-TB, with higher multimorbidity burden in older, male, and MDR-TB cohorts. MDR-TB patients exhibited distinct clusters (e.g., anemia exhibited significant multimorbidity with neutropenia [ρ = 0.150, P < 0.001] and hypoproteinemia [ρ = 0.254, P < 0.001]), while NDR-TB patients showed stronger type 2 diabetes mellitus (T2DM)-cardiovascular linkages. Adjusted GLMs demonstrated that MDR-TB status (β = −9.24%, 95% CI [−13.93, −4.40], P < 0.001) decreased the total health expenditure (THE), while multimorbidity count (β = 4.71%, 95% CI [4.19, 5.23], P < 0.001), prolonged hospitalization (β = 6.82%, 95% CI [6.61, 7.04], P < 0.001), Urban and Rural Resident Basic Medical Insurance (URRBMI; β = 36.89%, 95% CI [34.31, 39.51], P < 0.001), and no insurance (β = 164.43%, 95% CI [151.18, 172.10], P < 0.001) independently increased out-of-pocket (OOP) expense.

Conclusion

Integrated TB-noninfectious chronic disease (NCD) screening, optimized treatment protocols to address drug interactions, and policy reforms should be implemented to address the growing burden of TB multimorbidity in low- and middle-income countries (LMICs).