Food for thought: addressing undernutrition to end tuberculosis

Sinha, Pranay; Lönnroth, Knut; Bhargava, Anurag; Heysell, Scott K; Sarkar, Sonali; Salgame, Padmini; Rudgard, William E.; Boccia, Delia; Aartsen, Daniel Van; Hochberg, Natasha S.

doi:10.1016/s1473-3099(20)30792-1

Cited by 62 publications

(47 citation statements)

References 43 publications

(40 reference statements)

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“… 7 , 14 , 15 There are growing calls to address the problem of undernutrition to reduce TB incidence at population level and to improve treatment outcomes among people with active TB. 16 …”

Section: Introductionmentioning

confidence: 99%

“…7,14,15 There are growing calls to address the problem of undernutrition to reduce TB incidence at population level and to improve treatment outcomes among people with active TB. 16 In DRTB, undernutrition is associated with unfavourable treatment outcomes across several cohorts in low-, middle -and high-income countries. [17][18][19][20][21][22][23][24][25][26][27] Moreover, undernutrition is associated with TB relapse and mortality even after DRTB treatment completion.…”

Section: Introductionmentioning

confidence: 99%

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Undernutrition and Treatment Success in Drug-Resistant Tuberculosis in Uganda

Baluku¹,

Namiiro²,

Nabwana

et al. 2021

IDR

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Background Undernutrition is associated with unfavourable treatment outcomes among people with drug-resistant tuberculosis (DRTB). Factors influencing the treatment outcomes among undernourished people with DRTB are not well characterised. The aim of this study was to determine factors associated with treatment success among undernourished people with DRTB in Uganda. Methods We analysed data from a retrospective cohort of people with DRTB from 16 treatment sites in Uganda. We included participants with a pre-treatment body mass index (BMI) of <18.5 kilograms/meters 2 (kg/m 2 ). Participants were categorised as having mild (BMI of 18.5–17 kg/m 2 ), moderate (BMI of 16.9–16.0 kg/m 2 ) or severe (BMI of <16.0 kg/m 2 ) undernutrition. We performed logistic regression analysis to determine factors associated with treatment success. Results Among 473 people with DRTB, 276 (58.4%) were undernourished (BMI < 18.5 Kg/m 2 ) and were included in the study. Of these, 92 (33.3%) had mild, 69 (25.0%) had moderate and 115 (41.7%) had severe undernutrition. The overall treatment success rate (TSR) for the undernourished was 71.4% (n = 197). Although the TSR was similar among participants with mild (71.7%), moderate (78.3%) and severe (67.0%) undernutrition (p = 0.258), all treatment failure cases (n =6) were among participants with severe undernutrition (p = 0.010). Cigarette smoking (odds ratio (OR) = 0.19, 95% CI 0.07–0.47, p < 0.001), urban residence (OR = 0.31, 95% CI 0.14–0.70, p = 0.005) and moderate (OR = 0.14, 95% CI 0.06–0.35, p < 0.001) and severe anaemia (OR = 0.06, 95% CI 0.01–0.29, p = 0.001) were associated with lower odds of treatment success. Conclusion Most undernourished people with DRTB have severe undernutrition. Smoking and anaemia are modifiable factors which upon appropriate intervention could improve treatment success. The effect of urban residence on the TSR needs to be evaluated further.

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“… 7 , 14 , 15 There are growing calls to address the problem of undernutrition to reduce TB incidence at population level and to improve treatment outcomes among people with active TB. 16 …”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Undernutrition and Treatment Success in Drug-Resistant Tuberculosis in Uganda

Baluku¹,

Namiiro²,

Nabwana

et al. 2021

IDR

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“…Pathophysiologically, data suggest multiple targets of alcohol use, including direct impairment of cell-mediated immunity [126], direct impact on the upper respiratory tract [127], indirect impact on adaptive immunity [128], and malnutrition [129,130], as pathways for increased susceptibility to TB.…”

Section: Biological Mechanismsmentioning

confidence: 99%

Alcohol Use and the Risk of Communicable Diseases

et al. 2021

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The body of knowledge on alcohol use and communicable diseases has been growing in recent years. Using a narrative review approach, this paper discusses alcohol’s role in the acquisition of and treatment outcomes from four different communicable diseases: these include three conditions included in comparative risk assessments to date—Human Immunodeficiency Virus (HIV)/AIDS, tuberculosis (TB), and lower respiratory infections/pneumonia—as well as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) because of its recent and rapid ascension as a global health concern. Alcohol-attributable TB, HIV, and pneumonia combined were responsible for approximately 360,000 deaths and 13 million disability-adjusted life years lost (DALYs) in 2016, with alcohol-attributable TB deaths and DALYs predominating. There is strong evidence that alcohol is associated with increased incidence of and poorer treatment outcomes from HIV, TB, and pneumonia, via both behavioral and biological mechanisms. Preliminary studies suggest that heavy drinkers and those with alcohol use disorders are at increased risk of COVID-19 infection and severe illness. Aside from HIV research, limited research exists that can guide interventions for addressing alcohol-attributable TB and pneumonia or COVID-19. Implementation of effective individual-level interventions and alcohol control policies as a means of reducing the burden of communicable diseases is recommended.

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“…Tuberculosis is a very ancient disease, and some studies have pointed out that Mycobacterium tuberculosis infected humans five thousand years ago ( Sinha et al, 2021 ). Tuberculous pleurisy is a kind of extrapulmonary tuberculosis, which also includes bone tuberculosis, lymphoid tuberculosis and so on ( Reichler et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Identification of Hub Genes Associated With Tuberculous Pleurisy by Integrated Bioinformatics Analysis

Shi

Zhu

et al. 2021

Front. Genet.

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Improving the understanding of the molecular mechanism of tuberculous pleurisy is required to develop diagnosis and new therapy strategies of targeted genes. The purpose of this study is to identify important genes related to tuberculous pleurisy. In this study, the expression profile obtained by sequencing the surgically resected pleural tissue was used to explore the differentially co-expressed genes between tuberculous pleurisy tissue and normal tissue. 29 differentially co-expressed genes were screened by weighted gene co-expression network analysis (WGCNA) and differential gene expression analysis methods. According to the functional annotation analysis of R clusterProfiler software package, these genes are mainly enriched in nucleotide−sugar biosynthetic process (biological process), ficolin−1−rich granule lumen (cell component), and electron transfer activity (molecular function). In addition, in the protein-protein interaction (PPI) network, 20 hub genes of DEGs and WCGNA genes were identified using the CytoHubba plug-in of Cytoscape. In the end, RPL17 was identified as a gene that can be the biomarker of tuberculous pleurisy. At the same time, there are seven genes that may have relationship with the disease (UBA7, NDUFB8, UQCRFS1, JUNB, PSMC4, PHPT1, and MAPK11).

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Food for thought: addressing undernutrition to end tuberculosis

Cited by 62 publications

References 43 publications

Undernutrition and Treatment Success in Drug-Resistant Tuberculosis in Uganda

Undernutrition and Treatment Success in Drug-Resistant Tuberculosis in Uganda

Alcohol Use and the Risk of Communicable Diseases

Identification of Hub Genes Associated With Tuberculous Pleurisy by Integrated Bioinformatics Analysis

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