Publication date: Nov 29, 2024

With the rise of non-communicable diseases (NCDs) in a country that is already facing high tuberculosis (TB) burden, TB multi-morbidity is likely to pose a significant public health challenge in Pakistan. Data were analysed to determine the prevalence of TB and explore the distribution and determinants of multi-morbidity associated with TB in the population of Khyber Pakhtunkhwa -a province of Pakistan. This is a secondary analysis of data gathered as part of the KPIPHS survey conducted in 2016-17 in both the rural and urban areas of Khyber Pakhtunkhwa, Pakistan. An interviewer-administered questionnaire was used to collect data, from adults, on demographics, education and socioeconomic status, physical and mental health, reproductive health, child health, health-related quality of life, and self-reported cardiometabolic diseases including Diabetes, hypertension, renal disorders, cardiac failure, angina, and stroke. A total of 20,715 participants were recruited in the survey including 52. 8% (n=10,943) males and 47. 2% (n=9,772) females with a mean age of 41 (13. 1) years. Data on TB status was available for a total of 14452 participants. The prevalence of TB in Khyber Pakhtunkhwa was found to be 0. 49% (n=72) including an almost equal number of males and females [48% (n=34) vs 51% (n=36)], respectively. The mean age of the patients with TB was 47. 5 (11. 6) years. A higher proportion of people with TB had cardiometabolic diseases compared to people without TB (45. 9% vs. 30. 9%). Amongst the cardiometabolic disorders, self-reported hypertension (OR: 1. 81, 95% CI 1. 08-3. 02, p=0. 02), Diabetes (OR: 3. 99, 95% CI 1. 95-8. 18, p=

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