Article

Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania.

Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease (impact factor: 2.73). 10/2011; 15(10):1380-9. DOI:10.5588/ijtld.10.0784 pp.1380-9
Source: PubMed

ABSTRACT Patients with tuberculosis (TB) often suffer from profound malnutrition.
To examine the patterns and predictors of change in nutritional and hemoglobin status during and after TB treatment.
A total of 471 human immunodeficiency virus (HIV) positive and 416 HIV-negative adults with pulmonary TB were prospectively followed in Dar es Salaam, Tanzania. All patients received 8 months' TB treatment following enrollment.
About 40% of HIV-positive and 47% of HIV-negative TB patients had body mass index (BMI) < 18.5 kg/m 2 at baseline, while about 94% of HIV-positive and 84% of HIV-negative participants were anemic at baseline. Both HIV-positive and HIV-negative patients experienced increases in BMI and hemoglobin concentrations over the course of TB treatment. Among HIV- positive patients, older age, low CD4 cell counts, and high viral load were independently associated with a smaller increase in BMI from baseline to 8 months. Fe- male sex, older age, low CD4 cell counts, previous TB infection and less money spent on food were independently associated with a smaller improvement in hemoglobin levels among HIV-positive patients during treatment.
HIV-positive TB patients, especially those with low CD4 cell counts, showed poor nutritional recovery during TB treatment. Adequate nutritional support should be considered during TB treatment.

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  • Article: Nutritional status and weight gain in patients with pulmonary tuberculosis in Tanzania.
    N Kennedy, A Ramsay, L Uiso, J Gutmann, F I Ngowi, S H Gillespie
    [show abstract] [hide abstract]
    ABSTRACT: We assessed nutritional status in 200 adult Tanzanian patients with smear-positive pulmonary tuberculosis before, during, and after 6 months of tuberculosis treatment; 148 patients (74%) were successfully followed for 12 months. Marked nutritional impairment was present on admission: 77% of males and 58% of females had a body mass index (BMI) below 18.5; approximately one-fifth had BMI < 16.0. The length of hospital stay and gender, rather than microbiological response, were the major determinants of weight gain during treatment. Patients infected with human immunodeficiency virus (HIV) gained more weight than uninfected patients. Most patients lost weight after completing treatment and returning home. At 12 months, 32% of male and 19% of female patients considered cured of tuberculosis had BMI < 18.5. It is concluded that patients with tuberculosis from this area of Tanzania frequently have evidence of malnutrition both before and after treatment for tuberculosis. Weight gain during therapy appeared to be an unreliable indicator of overall treatment response. However, the results also demonstrated that nutritional rehabilitation can be successfully achieved even in HIV-positive tuberculosis patients and in patients with a suboptimal response to therapy.
    Transactions of the Royal Society of Tropical Medicine and Hygiene 90(2):162-6. · 2.16 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

416 HIV-negative adults
 
471 human immunodeficiency virus
 
8 months
 
8 months' TB treatment
 
Adequate nutritional support
 
Dar es Salaam
 
Fe- male sex
 
HIV- positive patients
 
HIV-negative participants
 
HIV-negative patients
 
HIV-negative TB patients
 
HIV-positive patients
 
HIV-positive TB patients
 
increases
 
poor nutritional recovery
 
previous TB infection
 
profound malnutrition
 
pulmonary TB
 
smaller increase
 
viral load