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Predictors of Nutritional Status in Patients Treated for Multidrug-Resistant Tuberculosis at a Referral Hospital in Tanzania | OMICS International| Abstract
2476-213X

Journal of Clinical Infectious Diseases & Practice
Open Access

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  • Research Article   
  • J Clin Infect Dis Pract 2016, Vol 1(2): 115
  • DOI: 10.4172/2476-213X.1000115

Predictors of Nutritional Status in Patients Treated for Multidrug-Resistant Tuberculosis at a Referral Hospital in Tanzania

Flora S Nyaki1,2, Merete Taksdal3, Alexander W Mbuya1, Margareth Sariko2,4, Isaack A Lekule1, Riziki M Kisonga1, Gibson S Kibiki2,4,6, Blandina T Mmbaga2,4, Scott K Heysell5 and Stellah G Mpagama1*
1Kibong’oto Infectious Disease Hospital, Kilimanjaro, , Tanzania
2Kilimanjaro Christian Medical University College, Moshi, , Tanzania
3LHL International TB Foundation, Oslo, , Norway
4Kilimanjaro Clinical Research Institute, Kilimanjaro, , Tanzania
5Division of Infectious Diseases and International Health, University of Virginia, USA
6East African Health Research Commission (EAHRC), Bujumbura, , Burundi
*Corresponding Author : Stellah G Mpagama, Kibong’oto Infectious Diseases Hospital, Kilimanjaro, Tanzania, Tel: +255272756754, Email: [email protected]

Received Date: Oct 26, 2016 / Accepted Date: Dec 12, 2016 / Published Date: Dec 16, 2016

Abstract

Tuberculosis (TB) and malnutrition co-exist. Malnutrition predisposes to development of TB, and may further predict treatment outcomes. Given that paucity of data regarding malnutrition in specific populations with multidrugresistant (MDR)-TB, we aimed to determine the pre-treatment and post-treatment change in nutrition status, as measured by body mass index (BMI), in patients from Tanzania initiating MDR-TB treatment, as well as potentially modifiable determinants of BMI in this population at high-risk for treatment failure.

Design: A retrospective cohort was followed consisting of patients admitted for MDRTB treatment at Kibong'oto National MDR-TB Center of Excellence, the national referral hospital for all cases in Tanzania.

Results: Of 104 MDR-TB cases admitted from November 2013 through June 2014, 96 (92%) cases were assessed for nutrition status. Fifty-one (53%) were malnourished, of which 15 (30%), 15 (30%) and 21 (45%) were classified as mild (BMI <18.5 - 17), moderate (BMI <17 ≥ 16) and severe (BMI <16) respectively. Gender, HIV status, and pre-treatment CD4 count among those HIV infected did not influence pre-treatment nutrition status. Thirty-seven (39%) of MDR-TB patients improved grades (e.g. from severe to moderate malnutrition) and gained a mean BMI of 2 kg/m2 (95% CI: 1-3), yet 9 (9%) deteriorated grades and thus developed acute adult malnutrition during treatment. In those that developed acute malnutrition during treatment, the mean lost BMI was 3 kg/m2 (95% CI; 0.3-8). Categorical change in BMI grade trended toward association with the duration of inpatient admission (p=0.05).

Conclusion: Malnutrition is a common comorbidity in MDR-TB patients receiving treatment in Tanzania. Importantly, some MDR-TB patients while on treatment developed acute malnutrition. Given the lack of predictors of developing malnutrition, these findings suggest the need for frequent assessment of nutrition status during the course of MDR-TB treatment, to identify patients that may require additional therapeutic supplements.

Keywords: Multidrug resistant tuberculosis (MDR-TB); Malnutrition; Body Mass Index (BMI); HIV coinfection; Kibong'oto; Therapeutic nutrition; Intravenous nutrition

Citation: Nyaki FS, Taksdal M, Mbuya AW, Sariko M, Lekule IA, et al. (2016) Predictors of Nutritional Status in Patients Treated for Multidrug- Resistant Tuberculosis at a Referral Hospital in Tanzania. J Clin Infect Dis Pract 1: 115. Doi: 10.4172/2476-213X.1000115

Copyright: © 2016 Nyaki FS, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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