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A study on nutritional status and change in body mass index with treatment outcome in smear-positive pulmonary TB patients on DOTS in Amritsar city

Manisha Nagpal, Priyanka Devgun, Naresh Chawla.

Abstract
Background: The association between tuberculosis (TB) and malnutrition has been recognized for a long time. A body mass index (BMI) below 18.5 increases the risk of TB by 2–3 times. Conversely, an increase in body weight lowers the risk.

Objective: To assess the nutritional status and change of patients’ bodyweight over time depending on TB treatment outcome.

Materials and Methods: The study was conducted on newly identified smear-positive patients registered under DOTS in two treatment units present in Amritsar city, Punjab, India. BMI of every patient was calculated from the weight and height measurements at the time of registration and again on completion of treatment. Nutritional requirement of the subjects was calculated using the Harris–Benedict equation. Data management and analysis was done by using Microsoft excel and SPSS software, version 17.00.

Results: Of 250 patients, 149 (59.6%) were men and 101 (40.4%) women. Male preponderance, with male to female ratio of 1.5:1 was seen; 97.3% of the total men and all of the women were taking diet deficient in calories. It was observed that, in the beginning, 69.2% patients were underweight among which 34% are severely underweight having BMI < 16 kg/m2; 29.6% cases were having normal BMI, while only 1.2% cases were preobese. At the end of treatment, it was evident that 62.8% of the cases were still underweight, 34.9% of the cases showed normal BMI, and 2.3% were in the preobese category.

Conclusion: In this study, it was observed that that mean BMI in cured cases at the end of treatment was higher when compared with cases with outcome as failure. The results were found to be statistically significant. So, it was concluded that poor nutritional status is associated with unfavorable outcome in TB.

Key words: uberculosis, malnutrition, body mass index (BMI), directly observed treatment, short course (DOTS)



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