Nutritional status of tuberculosis patients, a comparative cross-sectional study.

Abstract

Background Each year, more than 13.7 million people became an active case of tuberculosis and more than 1.5 million cases of TB patient will die. The association between TB and malnutrition is bi-directional, TB leads the patient to malnutrition, and malnutrition increases the risk of developing active TB by 6 to 10 times. Improving the nutrition of individual greatly reduces tuberculosis. The aims of this study were to assess the nutritional status and determinants of underweight among TB patients.Methods A comparative cross-sectional study design was implemented. The sample size was calculated using 95% CI, 90% power, the prevalence of malnutrition in TB patients 50%, TB patients to TB free resident ratio of 3, the design effect of 2 and a 5% non-response rate. Systematic random sampling was used to select TB patients and simple random sampling technique was used to select TB free residents. The data were collected from July 2015- May 2018. The data were collected by interviewing the patient, measuring anthropometric indicators and collecting the stool and blood samples. The data were entered into the computer using Epi-info software and analyzed using SPSS software. Descriptive statistics were used to find the proportion of malnutrition. Binary logistic regression was used to identify the determinants of malnutrition.Results A total of 5045 study participants (1681 TB patients and 3364 TB free residents) were included giving for the response rate of 93.1%. The prevalence of underweight among TB patients was 57.17% (95% CI: 54.80%, -59.54%) and 88.52% of TB patients were anemic. The prevalence of malnutrition (underweight) among TB free residents was 23.37% (95% CI: 21.93-24.80). The nutritional status of TB patients was determined by site of infection AOR: 0.68 [0.49-0.94], sex of the patient AOR: 0.39 [0.25-0.56], residence AOR: 3.84 [2.74-5.54], intestinal parasite infection AOR: 7 [5.2-9.95], problematic alcohol use AOR: 1.52 [1.17-2.13].Conclusion High proportions of TB patients were malnourished. TB patients were highly susceptible to malnutrition and even a very distal reason for malnutrition in the community became a proximal cause for TB patients.

Intestinal parasites co-infection among tuberculosis patients in Ethiopia: a systematic review and meta-analysis

“…Secondly, nine studies [ 3 , 4 , 15 – 17 , 19 – 21 ] reported the detection of H.worm and similarly nine [ 3 , 4 , 11 , 12 , 15 , 16 , 19 – 21 ] reported T.trichuria . Likewise, S.sterocolaris was reported by eight [ 3 , 4 , 12 , 14 – 16 , 19 , 20 ] studies. Among intestinal protozoans, G.lamblia was repeatedly reported by seven [ 11 , 12 , 15 , 16 , 19 – 21 ] studies.…”

“…Two hundred sixty-nine studies were screened by title and abstract. Finally, only 20 papers were found to be eligible for full-text evaluation, and 11 studies [ 3 , 4 , 11 , 12 , 14 – 17 , 19 – 21 ] that fulfilled the eligibility criteria were included in the final analysis (Table 1 , Fig. 1 ).…”

“…The sample size in each included study ranged from 43 to 1681 TB patients. However, except for a study done by Feleke et al [ 14 ] that screened 1681 TB patients for intestinal parasites, the sample size for each of the remaining 10 studies was below 300. To diagnose TB, most of the studies used smear microscopy while one study from Addis Ababa and the other study from northeast Ethiopia used Mycobacterial culture.…”

“…Accordingly, different combinations of stool examination methods were used. Ten [ 3 , 4 , 11 , 12 , 15 – 17 , 19 – 21 ], nine [ 3 , 7 , 11 , 12 , 14 , 15 , 17 , 19 , 21 ], three [ 4 , 14 , 21 ] and two studies [ 11 , 12 ] used direct saline examination, formol ether concentration, Kato-Katz and modified Ziehl Neelsen methods respectively. Two studies that used modified Ziehl Nelson staining method reported coccidian parasites co-infection among TB patients.…”

“…A 70.9% prevalence of intestinal helminthic co-infection among TB patients is reported from Northwest Ethiopia [ 3 ]. Some studies reported that there was a higher prevalence of intestinal parasite infection among TB patients compared to TB free individuals [ 3 , 11 , 12 , 14 ], while others reported no association between intestinal parasitic infection and TB [ 4 , 15 – 17 ]. Even though there are several usable studies with apparent variability in the country, to our knowledge, there is no conclusive evidence of tuberculosis and intestinal parasites co-infection.…”