Prevalence and patterns of multiple long-term conditions among lymphatic filariasis patients in Odisha, India: a community-based cross-sectional study

Neglected tropical diseases (NTDs), such as lymphatic filariasis, mimic other chronic conditions and share common risk behaviors with parallel health system issues that require unique interventions. Multiple long-term conditions (MLTCs or multimorbidity), defined as two or more chronic conditions has become increasingly common in low- and middle-income countries (LMICs) such as India. However, data on the prevalence of the interface between NTDs and other chronic conditions are lacking. We estimated the prevalence and correlates of MLTC, assessed the commonly occurring patterns, and investigated the association between self-rated health (SRH) and the number of chronic conditions among patients with lymphatic filariasis.

A cross-sectional study was conducted in Odisha, India, using a prevalidated MLTC assessment tool. We employed systematic random sampling to recruit 584 participants aged ≥ 18 years having lymphatic filariasis. MLTC was defined as the coexistence of one or more chronic conditions along with lymphatic filariasis. A multivariable logistic regression model was used to identify the correlates presented as adjusted odds ratios (AORs) with 95% confidence intervals (CIs). A hierarchical cluster analysis was conducted to identify the major clusters of chronic conditions. An ordinal regression model was used to assess the association between SRH and the number of chronic conditions.

The overall prevalence of MLTC was 68.8% (95% CI: 64.9-72.6), while the mean number of chronic conditions was 2 ± 2.3. The chance of having MLTCs was greater among males [AOR: 3.9 (95% CI: 2.1-7.3)] than females. Participants with education at the primary and secondary school levels had greater odds of having MLTC [AOR: 2.2 (95% CI: 1.3-3.7)] and [AOR: 2.3 (95% CI: 1.3-3.8)], respectively. The commonly observed triad was lymphatic filariasis with arthritis and peptic ulcer disease (1.5%), while the most common tetrad was lymphatic filariasis, hypertension, diabetes and peptic ulcer disease (0.7%). There was a per unit decrease in SRH with each additional chronic condition.

We observed a high prevalence of MLTC among people with lymphatic filariasis. The findings of this study will not only be useful for both resource and planning in India but also in similar LMICs with a high burden of lymphatic filariasis.