{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T21:53:38Z","timestamp":1791928418473,"version":"4.3.4"},"reference-count":35,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJTLD Open"],"accepted":{"date-parts":[[2025,11,11]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>We provided early screening and referrals for multimorbidity and absenteeism and assessed changes in these parameters from TB treatment start to completion in health facilities across Kenya, Uganda, Zambia, and Zimbabwe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A cohort study in 26 health facilities within national TB programmes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Follow-up was conducted in 1,146 (77%) of 1,497 patients; assessments took a median time of 30 min (interquartile range: 24\u201336). Symptom prevalence declined from 96% to 9%. Comorbidities (HIV, diabetes\/hyperglycaemia, hypertension\/high blood pressure) remained stable, while mental health disorders\/probable depression decreased from 7% to 4%. Multimorbidity fell markedly; disability (inability to walk 400 m in 6 min) decreased from 20% to 4%; and those with \u22653 multimorbidity conditions decreased from 20% to 8%. Work\/school absenteeism declined from 73% to 10%. Overall, referrals for care exceeded 85%, except for silica exposure (23%), smoking (57%), and recreational drug use (46%). Within-facility referrals were nearly 100%, except for silica exposure and disability (\u223c35%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Early interventions for multimorbidity led to major reductions in symptoms, risk factors, disability, and absenteeism, advocating for integration of patient-centred care throughout the TB care pathway. This multi-country study provides a promising roadmap for progress towards achieving this goal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.5588\/ijtldopen.25.0656","type":"journal-article","created":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T16:11:17Z","timestamp":1773850277000},"page":"177-184","source":"Crossref","is-referenced-by-count":4,"title":["Early interventions reduce multimorbidity and TB disability in Kenya, Uganda, Zambia, and 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