Nutritional status and weight gain in patients with pulmonary tuberculosis in Tanzania

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.

PIP: The authors assessed nutritional status in 200 adult Tanzanian patients with smear-positive pulmonary tuberculosis (TB) before, during, and after 6 months of TB treatment. 148 patients were successfully followed for 12 months. Upon admission, 77% of males and 58% of females had a body mass index (BMI) below 18.5, with about 20% having BMI less than 16.0. Most patients lost weight after completing treatment and returning home. At 12 months, 32% of male and 19% of female patients considered cured of TB had BMI less than 18.5. The length of hospital stay and gender, rather than microbiological response, were the major determinants of weight gain during treatment. Patients infected with HIV gained more weight than uninfected patients. The authors conclude that TB patients in Tanzania frequently have evidence of malnutrition both before and after treatment for TB. Weight gain during therapy appeared to be an unreliable indicator of overall treatment response. The study also demonstrated that nutritional rehabilitation can be successfully achieved even in HIV-positive TB patients and in patients with a suboptimal response to therapy.