A study on nutritional status and change in body mass index with treatment outcome in smear-positive pulmonary TB patients on DOTS in Amritsar city

Abstract

burden of poverty and undernutrition among both adults and children. [2] TB has been called "phthisis" owing to profound wasting. In a book published in 1949, which reviewed the epidemiological risk factors for TB at a global level, Dr. JB McDougall of the WHO stated: "The nutrition of the individual using the term in its widest sense, is the most vital factor in the prevention of tuberculous disease." [3] Malnutrition can predispose pulmonary tuberculosis (PTB). Conversely, PTB can result in malnutrition. Undernutrition selectively compromises cell-mediated immunity, which is the principal defense against Mycobacterium tuberculosis and, thereby, increases the risk of reactivation of latent infection to disease. [4] Moreover, poor nutritional status is associated with risk of TB relapse and mortality. [5] Background: The association between tuberculosis (TB) and malnutrition has been recognized for a long time. A body mass index (BMI) below 18.5 increases the risk of TB by 2-3 times. Conversely, an increase in body weight lowers the risk. Objective: To assess the nutritional status and change of patients' bodyweight over time depending on TB treatment outcome. Materials and Methods: The study was conducted on newly identified smear-positive patients registered under DOTS in two treatment units present in Amritsar city, Punjab, India. BMI of every patient was calculated from the weight and height measurements at the time of registration and again on completion of treatment. Nutritional requirement of the subjects was calculated using the Harris-Benedict equation. Data management and analysis was done by using Microsoft excel and SPSS software, version 17.00. Results: Of 250 patients, 149 (59.6%) were men and 101 (40.4%) women. Male preponderance, with male to female ratio of 1.5:1 was seen; 97.3% of the total men and all of the women were taking diet deficient in calories. It was observed that, in the beginning, 69.2% patients were underweight among which 34% are severely underweight having BMI < 16 kg/m 2 ; 29.6% cases were having normal BMI, while only 1.2% cases were preobese. At the end of treatment, it was evident that 62.8% of the cases were still underweight, 34.9% of the cases showed normal BMI, and 2.3% were in the preobese category. Conclusion: In this study, it was observed that that mean BMI in cured cases at the end of treatment was higher when compared with cases with outcome as failure. The results were found to be statistically significant. So, it was concluded that poor nutritional status is associated with unfavorable outcome in TB.

Determinants of Undernutrition among Adult Tuberculosis Patients Receiving Treatment in Public Health Institutions in Shashemane Town, Southern Ethiopia

“…The magnitude was much lower than in studies conducted in Amritsar, India (69.2 percent) [ 6 ], Timor and Rote Islands (87 percent) [ 9 ], Malawi (59 percent) [ 12 ], Kenya (43 percent) [ 10 ], and Limbe and Buea Regional Hospitals, Cameroon (78.21). [ 11 ].…”

“…Moreover, age of participant, average household monthly income, current place of residence, eating problem, and provision of nutrition support were factors significantly associated with undernutrition among adult TB patients. e magnitude was much lower than in studies conducted in Amritsar, India (69.2 percent) [6], Timor and Rote Islands (87 percent) [9], Malawi (59 percent) [12], Kenya (43 percent) [10], and Limbe and Buea Regional Hospitals, Cameroon (78.21). [11].…”

“…Few studies revealed that the magnitude of undernutrition among TB patients ranged from 52 to 90% in lowincome countries other than SSA countries [6][7][8][9], 43-78% in SSA [10][11][12][13] and 27.2% to 84.4%, [14][15][16][17][18][19] in Ethiopia.…”

Vitamin A Supplementation in Pulmonary Tuberculosis Patients on Acceleration of Sputum Conversion in Medan City

“…Otherwise, weight gain will reduce this risk. BMI in average increases in cured patients by the end of the medication compared to the patients who are not cured by the same time (Nagpal et al, 2014) [9].…”

Pengaruh Suplementasi Vitamin A pada Pengobatan Pasien TB Paru terhadap Percepatan Konversi Dahak pada Fase Intensif Di Wilayah Kerja Puskesmas Kecamatan Medan Kota

“…Sebaliknya, kenaikan berat badan akan menurunkan risikonya. Rata-rata IMT meningkat pada pasien yang sembuh pada akhir pengobatan jika dibandingkan dengan pasien yang tidak sembuh pada akhir pengobatan (15) Pengaruh suplementasi vitamin A pada pengobatan pasien TB paru terhadap percepatan konversi dahak fase intensif. Hasil uji statistik Mann-Whitney diperoleh nilai p sebesar < 0,001 yang masih dibawah nilai tingkat kemaknaan alpha sebesar 0,05, artinya ada pengaruh suplementasi vitamin A pada pengobatan pasien TB paru terhadap percepatan konversi dahak pada fase intensif di Wilayah Kerja terhadap fungsi kekebalan tubuh manusia.…”