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Li Y, Zhou H, Zhao C, Tan M, Shu L, Yang F. Nutritional support clinical efficacy in tuberculosis: quasi-experimental study. BMJ Support Palliat Care 2024:spcare-2023-004608. [PMID: 39209354 DOI: 10.1136/spcare-2023-004608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 07/15/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVE This study aimed to investigate the impact of nutritional support on the clinical efficacy in hospitalised tuberculosis patients with nutritional risk. METHODS We selected a total of 266 eligible patients with tuberculosis for the experimental and 190 patients for control groups. The patients in intervention group received adjusted dietary structure, enteral nutrition via oral intake or gastric tube, total parenteral nutrition and combined enteral and parenteral nutrition. We recorded various factors, including age, sex, underlying disease, tuberculosis type, nutritional risk at admission, serum albumin (ALB), body mass index, complications during hospitalisation, nutritional support status, serum ALB before discharge and length of hospital stay. RESULTS The incidences of nutritional risk in the control and experimental groups were 64.41% and 64.72%, respectively, with no statistically significant differences in baseline characteristics. The occurrence rates of complications and secondary infections in the experimental group were 57.89% and 51.5%, respectively, which were significantly lower than the control group's rates of 70.00% and 56.31%. These differences were statistically significant. The experimental group had a significantly shorter hospital stay (16.5±7.54 days) compared with the control group (19.55±7.33 days). Furthermore, the serum ALB levels of patients in the experimental group were higher on discharge than at admission. CONCLUSION Hospitalised patients with tuberculosis often face a high incidence of nutritional risk. However, the implementation of standardised nutritional support treatment has shown promising results in improving the nutritional status of tuberculosis patients with nutritional risk. This approach not only helps reduce the occurrence of complications but also enhances short-term prognosis and improves overall clinical efficacy.
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Affiliation(s)
- Yi Li
- Department of Infectious Diseases, Suining Central Hospital, Suining, China
| | - Hong Zhou
- Department of Infectious Diseases, Suining Central Hospital, Suining, China
| | - Chuan Zhao
- Department of Infectious Diseases, Suining Central Hospital, Suining, China
| | - Min Tan
- Department of Infectious Diseases, Suining Central Hospital, Suining, China
| | - Li Shu
- Suining Central Hospital, Suining, Sichuan, China
| | - Feng Yang
- Department of Infectious Diseases, Suining Central Hospital, Suining, China
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Sinha AK, Debata I, Pradhan PC, Panda PS, Behera BK, Mukhopadhyay A. A study to assess the nutritional status and dietary gap among pulmonary tuberculosis patients in Raipur city. J Family Med Prim Care 2024; 13:2138-2142. [PMID: 38948579 PMCID: PMC11213398 DOI: 10.4103/jfmpc.jfmpc_1948_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/16/2024] [Accepted: 02/19/2024] [Indexed: 07/02/2024] Open
Abstract
Background Undernutrition raises the likelihood of progressing from tuberculosis (TB) infection to active TB illness and causes weight loss. Proper food and nutrition are important in the treatment of tuberculosis patients. Active tuberculosis necessitates a substantial energy expenditure. The Tuberculosis treatment guidelines neglect the nutritional supplementation part of Tuberculosis management. The study aims to determine the factors affecting the nutritional status of pulmonary Tuberculosis patients. Material and Methods A hospital-based cross-sectional study was conducted from December 2021 to January 2022 among the patients newly diagnosed and above 18 years of age coming to DOTS Centre (DMC) of Pt J.N.M. Medical College, Raipur. Total 120 subjects were selected by consecutive sampling method. Data was analyzed using SPSS version 24, and P value <0.05 was considered statistically significant. Result Among 120 study subjects, malnourished was 54.16% (BMI <18.50 kg/m2), normal was 35% (BMI 18.50-24.99 kg/m2), overweight was 6.67% (BMI 25-29.99 kg/m2), and obese were 4.17% (BMI 30-34.99 kg/m2). Among 120 study subjects, the maximum number of them (96.3%) had a dietary gap in their diets which was equal in two groups of 1-50% calorie deficit and 51-100% calorie deficit. Conclusion A high proportion of tuberculosis patients were undernourished, and even a very distal factor for undernutrition became proximal for tuberculosis patients. To control tuberculosis and to end the tuberculosis disease, an improvement in the nutritional status of the patient should be our priority. By knowing the importance of nutrition in TB patients, the primary care physicians can decrease the morbidity and mortality in TB patients.
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Affiliation(s)
- Ashish Kumar Sinha
- Department of Community Medicine, Pt J N M Medical College, Raipur, Chhattisgarh, India
| | - Ipsita Debata
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | | | - Prem S. Panda
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Basanta K. Behera
- Department of Community Medicine, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Huang Y, Wu R, Xia Q, Liu L, Feng G. Prognostic values of geriatric nutrition risk index on elderly patients after spinal tuberculosis surgery. Front Nutr 2023; 10:1229427. [PMID: 37614748 PMCID: PMC10442490 DOI: 10.3389/fnut.2023.1229427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/26/2023] [Indexed: 08/25/2023] Open
Abstract
Background Spinal tuberculosis (STB) is a significant public health concern, especially in elderly patients, due to its chronic and debilitating nature. Nutritional status is a critical factor affecting the prognosis of STB patients. The geriatric nutritional risk index (GNRI) has been established as a reliable predictor of adverse outcomes in various diseases, but its correlation with surgical outcomes in elderly STB patients has not been studied. Objective The study aimed to assess the prognostic value of the GNRI in elderly patients with STB who underwent surgery. Methods We conducted a retrospective analysis of medical records of elderly patients (65 years or older) diagnosed with active STB who underwent surgical treatment. Data collection included patient demographics, comorbidities, clinical history, laboratory testing, and surgical factors. GNRI was calculated using serum albumin levels and body weight. Postoperative complications were observed and recorded. The patients were followed up for at least 1 year, and their clinical cure status was assessed based on predefined criteria. Results A total of 91 patients were included in the study. We found that a GNRI value of <98.63 g/dL was a cutoff value for predicting unfavorable clinical prognosis in elderly STB patients undergoing surgery. Patients with a low GNRI had higher Charlson Comorbidity Index scores, were more likely to receive red blood cell transfusions, and had a higher prevalence of overall complications, particularly pneumonia. The unfavorable clinical prognosis group had lower GNRI scores compared to the favorable prognosis group. Multivariate analysis showed that lower GNRI independently predicted unfavorable clinical outcomes in elderly STB patients. Conclusion The study concluded that the GNRI is a valuable biomarker for predicting prognosis in elderly STB patients undergoing surgical intervention. Patients with lower GNRI scores had worse outcomes and a higher incidence of complications.
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Affiliation(s)
- Yong Huang
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ruibang Wu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qinghong Xia
- Operating Room of Anesthesia Surgery Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, Sichuan, China
| | - Limin Liu
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ganjun Feng
- Department of Orthopedic Surgery and Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Nguyen TH, Nguyen THN, Le Xuan H, Nguyen PT, Nguyen KC, Le Thi TN. Nutritional status and dietary intake before hospital admission of pulmonary tuberculosis patients. AIMS Public Health 2023; 10:443-455. [PMID: 37304581 PMCID: PMC10251045 DOI: 10.3934/publichealth.2023031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 04/13/2023] [Accepted: 05/14/2023] [Indexed: 06/13/2023] Open
Abstract
Conducting research on nutritional status and dietary intake of pulmonary tuberculosis patients is essential for developing interventions in clinical nutrition practice and treatment during hospitalization, which can improve the quality of patients life. This cross-sectional descriptive study aimed to determine nutritional status and some related factors (such as geography, occupation, educational level, economic classification, etc.) of 221 patients with pulmonary tuberculosis who were examined and treated at the Respiratory Tuberculosis Department, National Lung Hospital in July 2019-May 2020. The results showed that the risk of undernutrition: According to BMI (Body Mass Index): 45.8% of patients were malnourished, 44.2% normal and 10.0% overweight/obese. According to MUAC (Mid-Upper Arm Circumference): 60.2% of patients were malnourished, 39.8% of patients were normal. According to SGA (Subjective Global Assessment): 57.9% of patients were at risk of undernutrition, of which 40.7% were at moderate risk of undernutrition and 17.2% risk of severe undernutrition. Classification of nutritional status according to serum albumin index: 50% of patients were malnourished, the rate of undernutrition of mild, moderate and severe levels was 28.9%, 17.9% and 3.2%, respectively. Most patients eat with others and eat less than four meals a day. The average dietary energy of patients with pulmonary tuberculosis in was 1242.6 ± 46.5 Kcal and 1084 ± 57.9 Kcal, respectively. 85.52% of patients did not eat enough food, 4.07% had enough, 10.41% consumed excess energy. The ratio of energy-generating substances in the diet (Carbohydrate:Protein:Lipid) was on average 54:18:28 for males and 55:16:32 for females. Most of the study population had diets that did not meet the experimental study in terms of micronutrient content. Specifically, more than 90% do not meet the requirements for magnesium, calcium, zinc, and vitamin D. The water-soluble and fat-soluble vitamins respond poorly, only about 30-40%. Selenium is the mineral with the best response rate, above 70%. Our findings revealed that the majority of the study subjects had poor nutritional status, as evidenced by diets lacking in essential micronutrients.
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Effect of Controlling Nutritional Status Score (CONUT) and Prognostic Nutritional Index (PNI) on patients after spinal tuberculosis surgery. Sci Rep 2022; 12:16056. [PMID: 36163373 PMCID: PMC9513047 DOI: 10.1038/s41598-022-19345-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/29/2022] [Indexed: 11/08/2022] Open
Abstract
The controlling nutritional status (CONUT) score and prognostic nutrition index (PNI) are immune-nutritional biomarkers that are related to clinical prognosis. Previous studies have reported using them to predict the prognosis of traumatic brain injury, tumours and other diseases. The purpose of this study was to evaluate the relationship between the PNI and CONUT score and the one-year prognosis of patients with spinal tuberculosis (STB). In this study, the clinical characteristics of 97 patients with STB who underwent debridement and internal fixation at our institution between 2015 and 2020 were retrospectively analysed. According to the receiver operating characteristic (ROC) curve, patients were divided into two groups: a high CONUT group and a low CONUT group. Patients were also divided into a high PNI group and a low PNI group. One-year postoperative prognosis was evaluated by the clinical cure standard. Patients in the favourable group were younger and had a lower rate of pneumonia and urinary tract infection, higher PNI and lower CONUT score than those in the favourable group (P < 0.05). There was an obvious correlation between the PNI and CONUT score (r = - 0.884, P < 0.05). The areas under the curve (AUCs) of the CONUT score and PNI for predicting unfavourable prognosis were 0.888 (95% CI 0.808-0.943, P < 0.001) and 0.896 (95% CI 0.818-0.949, P < 0.001), respectively. The adjusted odds ratios (ORs) of the CONUT score and PNI for predicting unfavourable outcomes were 2.447 (95% CI 1.518-4.043, P < 0.001) and 0.689 (95% CI 0.563-0.843, P < 0.001), respectively. Higher CONUT scores and a lower PNI were associated with adverse outcomes in patients with spinal tuberculosis, and the CONUT score and PNI might be independent predictors of adverse outcomes of spinal tuberculosis postoperatively.
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Investigating Spatial Patterns of Pulmonary Tuberculosis and Main Related Factors in Bandar Lampung, Indonesia Using Geographically Weighted Poisson Regression. Trop Med Infect Dis 2022; 7:tropicalmed7090212. [PMID: 36136622 PMCID: PMC9502094 DOI: 10.3390/tropicalmed7090212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 08/15/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Tuberculosis (TB) is a highly infectious disease, representing one of the major causes of death worldwide. Sustainable Development Goal 3.3 implies a serious decrease in the incidence of TB cases. Hence, this study applied a spatial analysis approach to investigate patterns of pulmonary TB cases and its drivers in Bandar Lampung (Indonesia). Our study examined seven variables: the growth rate of pulmonary TB, population, distance to the city center, industrial area, green open space, built area, and slum area using geographically weighted Poisson regression (GWPR). The GWPR model demonstrated excellent results with an R2 and adjusted R2 of 0.96 and 0.94, respectively. In this case, the growth rate of pulmonary TB and population were statistically significant variables. Spatial pattern analysis of sub-districts revealed that those of Panjang and Kedaton were driven by high pulmonary TB growth rate and population, whereas that of Sukabumi was driven by the accumulation of high levels of industrial area, built area, and slums. For these reasons, we suggest that local policymakers implement a variety of infectious disease prevention and control strategies based on the spatial variation of pulmonary TB rate and its influencing factors in each sub-district.
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Ter Beek L, Bolhuis MS, Jager-Wittenaar H, Brijan RXD, Sturkenboom MGG, Kerstjens HAM, de Lange WCM, Tiberi S, van der Werf TS, Alffenaar JWC, Akkerman OW. Malnutrition assessment methods in adult patients with tuberculosis: a systematic review. BMJ Open 2021; 11:e049777. [PMID: 35344503 PMCID: PMC8719177 DOI: 10.1136/bmjopen-2021-049777] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 11/19/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Malnutrition is associated with a twofold higher risk of dying in patients with tuberculosis (TB) and considered an important potentially reversible risk factor for failure of TB treatment. The construct of malnutrition has three domains: intake or uptake of nutrition; body composition and physical and cognitive function. The objectives of this systematic review are to identify malnutrition assessment methods, and to quantify how malnutrition assessment methods capture the international consensus definition for malnutrition, in patients with TB. DESIGN Different assessment methods were identified. We determined the extent of capturing of the three domains of malnutrition, that is, intake or uptake of nutrition, body composition and physical and cognitive function. RESULTS Seventeen malnutrition assessment methods were identified in 69 included studies. In 53/69 (77%) of studies, body mass index was used as the only malnutrition assessment method. Three out of 69 studies (4%) used a method that captured all three domains of malnutrition. CONCLUSIONS Our study focused on published articles. Implementation of new criteria takes time, which may take longer than the period covered by this review. Most patients with TB are assessed for only one aspect of the conceptual definition of malnutrition. The use of international consensus criteria is recommended to establish uniform diagnostics and treatment of malnutrition. PROSPERO REGISTRATION NUMBER CRD42019122832.
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Affiliation(s)
- Lies Ter Beek
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Tuberculosis Center Beatrixoord, University of Groningen, University Medical Center Groningen, Haren, The Netherlands
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mathieu S Bolhuis
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Harriët Jager-Wittenaar
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - René X D Brijan
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, and Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marieke G G Sturkenboom
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Huib A M Kerstjens
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Wiel C M de Lange
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Tuberculosis Center Beatrixoord, University of Groningen, University Medical Center Groningen, Haren, The Netherlands
| | - Simon Tiberi
- Department of Infection, Barts Health NHS Trust, London, UK
- Blizard Institute, Queen Mary University of London, London, UK
| | - Tjip S van der Werf
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jan-Willem C Alffenaar
- Faculty of Medicine and Health, University of Sydney, School of Pharmacy, Sydney, New South Wales, Australia
- Westmead Hospital, Sydney, New South Wales, Australia
- Marie Bashir Institute for Infectious Diseases and Biosecurity, University of Sydney, Sydney, Australia
| | - Onno W Akkerman
- Department of Pulmonary Diseases and Tuberculosis, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Tuberculosis Center Beatrixoord, University of Groningen, University Medical Center Groningen, Haren, The Netherlands
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Appiah PK, Osei B, Amu H. Factors associated with nutritional status, knowledge and attitudes among tuberculosis patients receiving treatment in Ghana: A cross-sectional study in the Tema Metropolis. PLoS One 2021; 16:e0258033. [PMID: 34648547 PMCID: PMC8516225 DOI: 10.1371/journal.pone.0258033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 09/17/2021] [Indexed: 11/24/2022] Open
Abstract
Background Nutritional deficiencies are generally associated with increased risk and severity of tuberculosis. This study investigated the nutritional status, knowledge, and attitudes of tuberculosis (TB) patients receiving treatment in the Tema Metropolis. Method A cross-sectional design was used to collect data on the nutritional knowledge, attitude, and status of TB patients. Nutritional status was analysed using World Health Organization’s formula for body mass index. Pearson’s chi-square and logistic regression models were used to assess associations between predictor and outcome variables. All statistical analyses were considered significant at p-values < 0.05. Result The prevalence of malnutrition among TB patients was 39.7%, 14.4%, and 4.8% for underweight, overweight, and obesity respectively. There was a high (61.0%) knowledge of nutrition among the patients. Also, 65.8% had good attitude towards nutrition. There were significant associations between normal nutritional status and age of the TB patients (p = 0.041), highest educational level attained (p = 0.036), employment status (p = 0.019), status of alcohol intake (p = 0.031), number of months on TB treatment (p = 0.021), and attitude towards nutrition (p = 0.028). Conclusion There was a reasonable nutrition-related knowledge and attitude towards nutrition among the TB patients. However, that did not reflect on their nutritional status. We recommend continuing education on smoking cessation, avoidance of harmful use of alcohol, and the establishment of food aid and other livelihood intervention programs for TB patients.
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Affiliation(s)
- Prince Kubi Appiah
- Department of Family and Community Health, School of Public Health (Hohoe Campus), University of Health and Allied Sciences, Ho, Ghana
- Department of Medical Law and Ethics, Asian Institute for Bioethics and Health Law, College of Medicine, Yonsei University, Seoul, South Korea
- * E-mail: ,
| | - Bright Osei
- Department of Family and Community Health, School of Public Health (Hohoe Campus), University of Health and Allied Sciences, Ho, Ghana
| | - Hubert Amu
- Department of Population and Behavioural Sciences, School of Public Health (Hohoe Campus), University of Health and Allied Sciences, Ho, Ghana
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Degefa MG, Bezabih AM, Kahsay ZH, Belachew AB. Barriers and facilitators of nutrition assessment, counseling, and support for tuberculosis patients: a qualitative study. BMC Nutr 2021; 7:58. [PMID: 34641977 PMCID: PMC8513346 DOI: 10.1186/s40795-021-00463-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 08/20/2021] [Indexed: 11/29/2022] Open
Abstract
Background Nutrition has a substantial role in the prevention, treatment, and cure of tuberculosis. Thus, nutrition assessment, counseling, and support (NACS) have been implemented as part of tuberculosis treatment. However, evidence on the barriers and facilitators (enablers) of its implementation is lacking. Objective To explore barriers and facilitators of implementation of NACS for tuberculosis patients. Methods An exploratory qualitative study was conducted in public health facilities and health offices of Mekelle City, Northern Ethiopia. We conducted 17 interviews using purposively selected key informants comprising health professionals (n = 12) and tuberculosis patients (n = 5). Interviews were tape-recorded, transcribed verbatim, and coded and analyzed using a thematic approach in ATLAS.ti 7 software. Results Barriers were identified at three levels -organization, care provider, and patient levels. Suboptimal nutritional supply, lack of supportive supervision, lack of adequate workforce, staff turn-over, the sudden withdrawal of partners, and weak link with social service were the barriers at the organization level. Lack of commitment was reported as the only barrier at the care provider level, and socioeconomic status of patients, sharing and selling of supplies, perceived improved status, and perceived stigma were identified as the major barriers for the implementation of nutrition assessment, counseling, and support service. While training, availability of measurement and educational tools, the inclusion of nutrition indicators in the tuberculosis register, and the presence of collaborating partners were identified as facilitators at the organizational level. Patients’ motivation to know their health status was reported to be a facilitator at the patient level. Conclusions Organization, care provider, and patient-level barriers and facilitators were found to influence the implementation of NACS. Hence, multilevel factors should be considered to successfully implement the program and to gain its potential impact. Supplementary Information The online version contains supplementary material available at 10.1186/s40795-021-00463-x.
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Affiliation(s)
- Meaza Girma Degefa
- Department of Public Health, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia.
| | - Afework Mulugeta Bezabih
- Department of Nutrition and Dietetics, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Znabu Hadush Kahsay
- Department of Environmental Health and Behavioral Sciences, School of Public Health, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - Abate Bekele Belachew
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.,Center for Environmental and Respiratory Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland.,Biocenter Oulu, University of Oulu, Oulu, Finland
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Fitriyana WW, Ayuningrum DP. Factor Associated with Underweight among People with Tuberculosis. JURNAL BERKALA EPIDEMIOLOGI 2021. [DOI: 10.20473/jbe.v9i22021.202-210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: The relationship between Tuberculosis (TB) and nutritional status is a significant one. Patients with TB who are underweight face a higher risk of death. Purpose: This research aims to analyze the factors related to the occurrence of being underweight among TB patients at the Public Health Center (PHC) in Perak Timur, Surabaya. Method: This was an analytical observational study and used a cross-sectional design. The sample for this research was 41 respondents, who were TB patients and were undergoing treatment at the PHC in Perak Timur, Surabaya. Data collection was done from March 2020 to June 2020. Primary data was collected by conducting interviews using a questionnaire. Data analysis was performed using a chi-square test. Results: The results indicated that, out of the 41 respondents, there were 21 respondents who were underweight (51.22%). Descriptively, underweight TB patients were more likely to be in the intensive phase of treatment (90%), have a low income (56.76%), have a low education status (65.38%), and be unemployed (59.38%), with PR=0.43 and 95%CI=0.76–9.38. The results of this research indicated a link between the treatment phase and TB patients being underweight (p=0.01; PR=2.33; 95% CI=1.43–3.79), the level of education attained by underweight TB patients (p=0.04; PR=0.41; 95% CI=0.17–0.99), and the income of underweight TB patients (p=0.04; PR=0.43; 95%CI=0.30–0.63). The results of this research indicated that there was a correlation between the work status and TB patients being underweight (p=0.07; PR=2.67; 95%CI=0.76–9.38). Conclusion: The treatment phase, education level and income are significantly related to TB patients being underweight.
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Bohara SS, Thapa K, Bhatt LD, Dhami SS, Wagle S. Determinants of Junk Food Consumption Among Adolescents in Pokhara Valley, Nepal. Front Nutr 2021; 8:644650. [PMID: 33898498 PMCID: PMC8060464 DOI: 10.3389/fnut.2021.644650] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/24/2021] [Indexed: 12/19/2022] Open
Abstract
Background: Junk food consumption and its consequences has become a major public health concern globally because of its deteriorating health consequences and surging prevalence. Though its adverse health consequences are widely prevalent in all age groups, children and adolescents are more at risk. It may lead to obesity and act as a risk factor for different non-communicable diseases (NCD's) like heart diseases, cardiovascular disease, cancer, hypertension, diabetes, etc. This study was carried out to explore the junk food consumption and its associated factors among adolescent students. Methods: A cross-sectional study was conducted among 538 adolescent students of Kaski district, Nepal. We used a stratified proportionate sampling technique to recruit the participants. A self-administered questionnaire was used for data collection. Descriptive and bivariate statistical analysis was performed. The odds ratio was computed to test the association. Results: The study found that more than half of the participants (60.30%) consumed junk foods over the last 30 days, more prevalent among public school participants (65.1%) followed by participants of private school (56.3%). More than half of the participants consumed salty snacks (58.7%) followed by sweets (57.5%). The time of consumption was found to be higher together with friends (83.9%). Similarly, it was consumed more while the participants were on a trip (70.1%). Consumption of junk foods was significantly associated with public school (OR: 1.44, CI = 1.01-2.06), single family (OR: 1.46, CI = 1.01-2.10), living with parents (OR: 1.64, CI = 1.03-2.63), while on travel (OR: 1.99, CI = 1.33-2.98), while reading (OR: 2.01, CI = 1.16-3.47), at home (OR: 2.20, CI = 1.53-3.16), at school (OR: 2.86, CI = 1.98-4.12), friends' influence (OR: 2.01, CI = 1.37-2.94), and junk food availability at home (OR: 1.92, CI = 1.33-2.76). Conclusion: Consumption of junk foods among adolescent students was remarkably high in both public school and private school adolescents. Regardless of adequate knowledge on harmful consequences of junk foods, school-going adolescents are consuming junk foods due to its easy availability and ready-to-use packaging. The government of Nepal should strictly standardize and regulate advertising policies and extravagant health claims advertised by junk food manufacturers. An appropriate intervention targeted to adolescents to improve food behaviors is recommended.
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Affiliation(s)
- Suraj Sujan Bohara
- Faculty of Health Science, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
| | - Kanchan Thapa
- Independent Public Health Researcher, Kathmandu, Nepal
| | - Laxman Datt Bhatt
- Department of Healthcare Management, National Open College, Pokhara University, Kaski, Nepal
| | - Shankar Singh Dhami
- Faculty of Health Science, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
| | - Shreejana Wagle
- Faculty of Health Science, School of Health and Allied Sciences, Pokhara University, Kaski, Nepal
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Musuenge BB, Poda GG, Chen PC. Nutritional Status of Patients with Tuberculosis and Associated Factors in the Health Centre Region of Burkina Faso. Nutrients 2020; 12:nu12092540. [PMID: 32825756 PMCID: PMC7551284 DOI: 10.3390/nu12092540] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 08/19/2020] [Indexed: 02/07/2023] Open
Abstract
Extreme hunger and poverty remain a significant barrier to maintaining a normal and healthy life, and increase the burden of tuberculosis (TB) in sub-Saharan African countries. The purpose of this study was to assess the prevalence and factors associated with undernutrition among adult patients with TB in Burkina Faso. In the Health Centre Region of Burkina Faso, we conducted a cross-sectional survey with face-to-face interviews of patients aged 15 years and older with TB (n = 302), from March to April 2019. Undernutrition was defined as a body mass index of <18.5 kg/m2. Multiple logistic regression analyses were performed to determine the correlates of undernutrition. The prevalence of undernutrition was 35.8%, in which severe, moderate, and mild thinness were 7.7%, 8.9%, and 19.5%, respectively. Low food frequency per day (adjusted odds ratio [aOR] = 3.28, confidence interval [CI]: 1.42–7.55, p = 0.005), human immunodeficiency virus infection (aOR = 6.18, CI: 2.26–16.88, p < 0.001), and diabetes mellitus (aOR = 17.52, 95% CI: 1.88–162.97, p = 0.012) and young age (45–54 years vs. 65 years and older, aOR = 2.93, 95% CI: 1.11–7.70, p = 0.029) were associated with increased odds of undernutrition. We concluded that the assessment of comorbidity and nutritional status should be part of the treatment for adult TB patients.
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Affiliation(s)
- Beatrice B. Musuenge
- Department of Public Health, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City 40402, Taiwan;
| | - Ghislain G. Poda
- Public Health Department, University of Ouagadougou, Ouagadougou 03 BP 7021, Burkina Faso;
| | - Pei-Chun Chen
- Department of Public Health, China Medical University, 91 Hsueh-Shih Road, North District, Taichung City 40402, Taiwan;
- Correspondence: ; Tel.: +886-4-2205-3366 (ext. 6102)
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Undernutrition and Mortality among Adult Tuberculosis Patients in Addis Ababa, Ethiopia. Adv Prev Med 2020; 2020:5238010. [PMID: 32802521 PMCID: PMC7403904 DOI: 10.1155/2020/5238010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/20/2020] [Accepted: 07/06/2020] [Indexed: 11/17/2022] Open
Abstract
Background In developing countries, there are several adult tuberculosis (TB) patients suffering from profound undernutrition. Undernutrition is a significant risk factor for developing tuberculosis. In the world, TB is one of the top ten and leading causes of death. To appropriately intervene death of adult TB patients, it is crucial to understand the magnitude of undernutrition and its associated factors among them. The study assessed undernutrition and mortality among adult tuberculosis patients in Addis Ababa, Ethiopia. Methods Institutional-based retrospective study was conducted in Addis Ababa, Ethiopia, from January 2019 to August 2019. The total sample size of the study was 284. The source populations were TB patients who have followed up for TB treatment at public health facilities of Addis Ababa. The sample size was allocated to the selected health facilities proportional to their size, and study subjects were enrolled to the study during the study period. Data were collected by a structured data sheet from the selected health center registration book. Data were entered into Epi Data software and analyzed by using SPSS version 20. Descriptive statistical methods were used to summarize the sociodemographic characteristics of the study participants. Survival curves were generated using the Kaplan-Meier method for all TB patients. Result A total of 284 study participants were included in the study. It was found that 46.8% of the study population have undernutrition (BMI <18.5 kg/m2) at the time of registration for treatment. Out of undernourished patients, 54 (19.0%) had severe malnutrition and 78 (27.5%) had moderate undernutrition. At the end of the two-month intensive treatment period, the under nutrition prevalence declined to 38.7%. Of the 284 patients, 17 (6.0%) died before completing anti-TB treatment. Three quarters of all forms of TB deaths occurred within 57 days after the start of anti-TB treatment. The proportion of deaths by nutritional status at treatment initiation among normal, moderate acute malnutrition, and severe acute malnutrition TB patients was 3.1%, 8.9%, and 16.3%, respectively. Conclusion Almost half of the TB patients were undernourished at the start of anti-TB treatment based on BMI. From the malnourished, less than 20% of the participants gained weight and moved to normal weight at the end of the two-month intensive treatment period. The high death rate was reported among severely malnourished tuberculosis patients, but it needs a larger study to further understand predictors. To enhance the increment of nutritional status during treatment, the government should give attention to support nutritional supplements for TB patients.
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Hameed S, Zuberi FF, Hussain S, Ali SK. Risk factors for mortality among inpatients with smear positive pulmonary tuberculosis. Pak J Med Sci 2019; 35:1361-1365. [PMID: 31489007 PMCID: PMC6717484 DOI: 10.12669/pjms.35.5.919] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective To evaluate risk factors having significant effect on mortality of smear positive Pulmonary Tuberculosis (PTB) inpatients. Methods A descriptive cross-sectional study was conducted at Ojha Institute of Chest Diseases, Dow University Hospital Ojha Campus, Karachi. One hundred and seventy (170) inpatients of smear positive PTB confirmed by Acid Fast Bacilli (AFB) smear, aged between 13-80 years were enrolled by using consecutive sampling technique while patients with drug resistant Tuberculosis (TB) and extra pulmonary TB were excluded from the study. Selected patients were interviewed for collecting demographic data and risk factor data by using a standard questionnaire. Results Out of 170 PTB inpatients, mortality was observed in 23 (13.5%) patients among which male patients were 12 (52.2%), and female were 11 (47.8%). Mortality was significantly associated with increasing age (p=0.003), socioeconomic status (p=0.019), anemia (p=0.03), Chronic Liver Disease (CLD) (p=0.005), Diabetes Mellitus (DM) (p=0.001), Human Immunodeficiency Virus (HIV) (p=0.007), Hypertension (HTN) (p=0.006), recurrent TB (p=0.001), and smoking (p=0.001). Conclusion Increasing age, poverty, smoking history, and presence of comorbidities like DM, CLD, HIV, hypertension, and anemia are associated with higher mortality in smear positive PTB cases.
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Affiliation(s)
- Sidra Hameed
- Dr. Sidra Hameed, MBBS, DTCD. Chest Unit-II, Ojha Institute of Chest Diseases Dow University of Health Sciences, Karachi, Pakistan
| | - Faisal Faiyaz Zuberi
- Dr. Faisal Faiyaz Zuberi, MBBS, FCPS (Med), FCPS (Pulm), FCCP (USA). Associate Professor Pulmonology & Head Chest Unit-II, Ojha Institute of Chest Diseases Dow University of Health Sciences, Karachi, Pakistan
| | - Sagheer Hussain
- Dr. Sagheer Hussain, MBBS. Chest Unit-II, Ojha Institute of Chest Diseases Dow University of Health Sciences, Karachi, Pakistan
| | - Syed Khalid Ali
- Dr. Syed Khalid Ali, MBBS, DTCD, MCPS (Pulm). Chest Unit-II, Ojha Institute of Chest Diseases Dow University of Health Sciences, Karachi, Pakistan
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