Magnitude of undernutrition and associated factors among adult tuberculosis patients attending public health facilities in Haramaya District, Eastern Ethiopia

Abstract

Background Tuberculosis is one of the top ten causes of illness, death, and disability throughout the world. Undernutrition reduces immunity, which makes latent tuberculosis more likely to become active tuberculosis. Tuberculosis makes these conditions worse. The body of a person suffering from TB has an increased demand for energy, which often causes a TB patient to lose a significant amount of weight and this can worsen acute undernutrition. The aim of this study was to assess the magnitude of undernutrition and its associated factors among adult TB patients in public health facilities in Haramaya district, eastern Ethiopia. Methods Institution-based cross-sectional study was conducted among 330 adult tuberculosis patients on follow-up in public health facility of Haramaya District, eastern Ethiopia from January 10, 2021 to February 20, 2021. An anthropometric assessment was done after a face-to-face interview using a pretested structured questionnaire. SPSS 24 was used to analyze the data. Bivariable and multivariable logistic regression model was used to identify factors associated with undernutrition. Results The overall prevalence of undernutrition was 43.6% (95% CI 38.2–49.1%). Proportion of severe, moderate and mild undernutrition was 11.8%, 12.4%, and 19.4%, respectively. Age group of 18–24 years (AOR = 4.12; 95% CI 1.36–12.51), not have formal education (AOR = 1.76; 95% CI 1.01–3.08), having large family size (AOR = 2.62; 95% CI 1.43–4.82), low dietary diversity (AOR = 2.96; 95% CI 1.75–4.99), lack of latrine (AOR = 2.14; 95% CI 1.26–3.65), history of TB treatment (AOR = 2.56; 95% CI 1.19–5.54) and taking intensive phase of anti-TB drugs (AOR = 3.18; 95% CI 1.62–6.25) were factors found significantly associated with under nutrition. Conclusion The prevalence of undernutrition was high. Age, educational status, family size, dietary diversity, toilet facility, history of tuberculosis medication and intensive phase of anti-TB drugs were found significantly associated with undernutrition. The nutritional derangement could call for fast nutritional intervention in the management of pulmonary tuberculosis patients.

Magnitude and determinants of undernutrition among tuberculosis patients in Ethiopia: systematic review and meta-analysis

“…All of the twenty-two studies included in this study were published from 2006 to 2023 in peer review journals [ 16 – 36 ]. A total of 8001 study participants were included in the current systematic review and meta-analysis.…”

“…The smallest sample size was 95 from a study conducted in the Dire Dawa [ 27 ], and the largest sample size was 1681 from a study conducted in the Amhara region [ 29 ]. Fifteen included studies were cross-sectional in study design [ 16 – 21 , 24 – 26 , 28 – 32 , 36 ], three were retrospective cohort studies [ 22 , 23 , 34 ], and three were case-controls [ 27 , 33 , 35 ]. Regarding study setting, six studies were conducted in the Amhara region [ 17 , 25 , 28 , 29 , 34 , 36 ] two studies in the SNNPR [ 22 , 30 ], one study was from the Somali region [ 18 ], six studies were conducted in the Oromia region [ 16 , 18 , 20 , 26 , 31 , 35 ], two studies were conducted in Tigray [ 21 , 34 ], two studies were conducted in Addis Ababa [ 23 , 32 ] and two studies were from Dire Dawa [ 24 , 27 ].…”

“…Fifteen included studies were cross-sectional in study design [16-21, 24-26, 28-32, 36], three were retrospective cohort studies [22,23,34], and three were case-controls [27,33,35]. Regarding study setting, six studies were conducted in the Amhara region [17,25,28,29,34,36] two studies in the SNNPR [22,30], one study was from the Somali region [18], six studies were conducted in the Oromia region [16,18,20,26,31,35], two studies were conducted in Tigray [21,34], two studies were conducted in Addis Ababa [23,32] and two studies were from Dire Dawa [24,27]. The summary of the included articles is described in (Table 1).…”

“…To investigate the association between educational status and undernutrition among tuberculosis patients, three studies were included in the analysis [16,19,24]. A random-effects model was utilized to evaluate the association between education and undernutrition among tuberculosis patients (I2 = 84.9%, P-value = 0.001).…”

Prevalence and risk factors of malnutrition in patients with pulmonary tuberculosis: a systematic review and meta-analysis

“…Patients with malnutrition may be more susceptible to developing the disease due to impaired innate and adaptive immunity to Mycobacterium tuberculosis ( 12 ). Additionally, patients with PTB frequently experience elevated energy needs, reduced appetite, low dietary intake, and malabsorption, all of which are closely associated with malnutrition ( 13 ). Patients with tuberculosis are frequently associated with high mortality, length of time to convert sputum, risk of drug resistance, and liver damage from anti-tuberculosis medications, which has a significant impact on the outcome and clinical prognosis ( 10 , 14 – 16 ).…”