Get a printable copy (PDF file) of the complete article (491K), or click on a page image below to browse page by page. p=0.03). Information on radiographic extent of disease was lacking, but results of bacillary density in sputum, another marker of disease severity were available and used in the multivariable analyses.

To assess the association of the pre-treatment nutritional status with mortality during TB treatment. The composition of patients reflects the status of patients diagnosed at both primary and secondary care level. Men who died during treatment had significantly lower pre-treatment weights than those who were treated successfully (4 kg lower median weight), but in women this difference was not statistically significant.

Yes Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada. Exactly what that involves will depend on whether you have latent TB infection (LTBI) or active TB disease. Recent systematic reviews have established the role of under-nutrition as an important risk factor for reactivation of latent TB infection to TB disease [6,7], while obesity has been found to be protective against TB[8–10].

2. Patients who defaulted were excluded in the analyses of death.

1695 patients were diagnosed with pulmonary tuberculosis during 2004-2009. At such high prevalence the predictive value of a risk factor may be lost.

In this study following the WHO recommendations would have entailed hospitalization of nearly half of all diagnosed patients, a measure which was not feasible.

Some people develop TB disease soon after becoming infected (within weeks) before their immune system can fight the TB bacteria. Demographic, clinical, and anthropometric characteristics of all adult patients diagnosed with pulmonary tuberculosis at JSS (2004-2009).

JSS caters to the rural population through its community health programme in 54 villages, a secondary care level hospital which is accessed by people of over 1500 villages, and 3 outreach clinics serving the villages in the community health programme and other remote villages. However, there is strong evidence that proper nutritional care improves nutritional recovery for people who are undernourished, and therefore helps reduce general health risks.  The bi-directional association between undernutrition and TB leads to a high prevalence of undernutrition among people with TB. Discover a faster, simpler path to publishing in a high-quality journal. Yes Performed the experiments: A. Bhargava MC YJ BC AK RK RD MB RJ A. Benedetti MP DM. Analysis of the data without patient identifiers was done at McGill University after ethics approval from the Institutional Review Board at the Faculty of Medicine, McGill University, Montreal (IRB Study Number: A10-M111-11B).

We assessed nutritional status and selected treatment outcomes in a consecutive cohort of 1695 patients over 18 years of age diagnosed with pulmonary tuberculosis at a rural hospital and community health programme in central India between 2004-2009.

Pulmonary tuberculosis (PTB) is a chronic respiratory disease common among crowded and poorly ventilated areas.

Heights were recorded to the nearest centimeter with a stadiometer using standard procedures. Nutrition assessment and management are key components of TB treatment 4.

Drug-Resistant TB. Outcomes were classified according to WHO guidelines as ‘Cured’ or ‘Treatment completed’ (these categories together constituted “treatment success”) ‘Deaths’, ‘Defaults’, ‘Treatment failure’, or ‘Transferred out’(i.e. The sampling of consecutive patients makes selection bias less likely, though because of the location and low-cost nature of services, the poor might have been over-represented in our cohort.

Patients who opted for treatment at JSS received daily, self-administered, short course therapy prescribed according to WHO Guidelines[26].

of patients with family history of TB, (%). Overall, 843 of 1523 (55%) of patients whose BMI was measured had severe underweight at diagnosis (data not in table). Age, weight and BMI were included as continuous variables in the regression model after verifying the linearity of associations under study in a generalised additive model. Only about one-third of men and a quarter of women had BMIs in the normal range after successful treatment (see Figure 2). About 10% of latent infections progress to active disease which, if left untreated, kills about half of those affected. Weights and BMIs of patients after successful treatment are shown in table 3.

There was no statistically or clinically significant difference in weights of men and women according to smear status, treatment history, HIV and diabetes status, year of diagnosis or location of residence (data not shown in table). The association observed between BMI and death during TB treatment was mainly driven by a strong association in men.

Levels of BMI which are considered lethal [36]- BMI< 13 kg/m2 and BMI <11 kg/m2 in men and women respectively- were seen in 5% of patients.
1179 patients of these 1695 patients were treated at JSS, while 516 patients were transferred out for treatment under the RNTCP. A significant proportion had history of a family member with active TB; of these, many had died. Patients with a previous history of TB treatment had a higher rate of default.

52% of patients (57% of men and 48% of women) had stunting with heights below the 3rd percentile of the National Center for Health Statistics(NCHS) standards for height at 18 years of age (163 cm for men and 151 cm for women).

Testing & Diagnosis. of patients with pulmonary TB & Diabetes mellitus,(%) of tested, No. medical icon. Overall, about 5 to 10% of infected persons who do not receive treatment for latent TB infection will develop TB disease at some time in their lives.
medical icon.


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