Nutritional status of tuberculosis patients, a comparative cross-sectional study [post]

2019 unpublished
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
more » ... 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. Background 3 Underweight is a malnutrition stage in which the body mass index (BMI) of adult scores less than 18.5 KG/M 2 cut-points [1, 2]. It results from an imbalance between the supply of food and the body demands for the nutrients. Conditions like genetics, metabolism disorders, medication side effects, eating disorders, and tuberculosis predispose to underweight [3, 4]. Tuberculosis (TB) is an infectious disease caused by bacterial species called M. tuberculosis. According to the world health organization (WHO), tuberculosis attacks 10 million people and kills 1.3 million people every year [5]. The association between TB and malnutrition is bi-directional, TB predisposes the patient to malnutrition and malnutrition increases the risk of developing active TB by 6 to 10 folds [6-12]. One-quarter of TB in the world was as a result of malnutrition, improving the nutritional status of the individual decreases the risk of TB [13]. Additionally, malnutrition increases TB relapse and mortality [14-21]. The treatment outcomes of TB patients can be improved by studying their nutritional status [14, 21]. Incorporating nutritional support during directly observed treatment strategy (DOTS) increases the probability of favorable treatment outcomes [22][23] [24] [25] [26] . [20, [27] [28] [29] . The prevalence of malnutrition in the South American continent range from 20 % -50 % [30, 31], in the Asian continent malnutrition among TB patient ranges from 68.6 % -87 % [12, 21] and in the United Kingdom, the body mass index of TB patients was 13% lower than the general community [32]. In the African continent, 29 % -61 % of TB patients were malnourished [15, 26, [33] [34] [35] [36]. The tuberculosis treatment guideline neglects the nutritional supplementation part of an intervention. Priority was not given by decision-makers as a result of evidence scarcity. This study will generate baseline information to give priority for the nutritional intervention part of TB treatment. The objectives of this research were to estimate and compare the proportion of underweight and their determinants among the TB patients in a resource-limited setting.
doi:10.21203/rs.2.10457/v4 fatcat:dmdjoejfwnd2pnf7iysdklmc6a