In a subgroup analysis the association of pre-treatment BMI with TB death was found to be statistically significant only in men. of patients with Pulm. The weight gain in this study was similar to the mean weight gain of 3.2 kg observed in another study in South India [41]. Pre-treatment, post-treatment weights & body mass index (BMI) in 756 patients with pulmonary TB who completed treatment successfully, (2004-2009). Patients were diagnosed primarily on the basis of sputum smear microscopy and radiography, according to WHO guidelines[26]. 3. This poor attainment of adult stature suggests chronic inadequate nutrition in childhood during the growth period [34,35]. Wrote the manuscript: A. Bhargava MC YJ BC RD MB MP DM. ; Tuberculosis is an infectious disease that primarily affects the lung parenchyma. Yes

Competing interests: The authors have declared that no competing interests exist. *BMI of 18.5 kg/m2 is the cutoff separating under-nutrition (BMI<18.5 kg/m2) from normal range of BMI (18.5-24.99 kg/m2). 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. Under-nutrition in adults in rural Chhattisgarh is highly prevalent.

Women were more likely to have severe nutritional deficit. * OR scaled to represent increase of age of 10 years. 2. The finding of severe and life-threatening levels of under-nutrition in this cohort of patients from rural India raises the issue of its management.

We conclude that nutritional support should be considered for severely underweight patients with pulmonary TB to decrease their risk of mortality, although community based nutritional interventions for such patients in rural India, require further investigation. Conceived and designed the experiments: A. Bhargava MC YJ BC AK RK MB RJ MP DM. Performed the experiments: A. Bhargava MC YJ BC AK RK RD MB RJ A. Benedetti MP DM. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US. Patients who defaulted were excluded in the analyses of death. Affiliation

Patients with a previous history of TB treatment had a higher rate of default. Death during treatment was significantly lower with greater pre-treatment body mass index, when adjusted for the covariates of age, gender, treatment category, sputum smear and HIV status. Exactly what that involves will depend on whether you have latent TB infection (LTBI) or active TB disease. Severe under-nutrition at diagnosis was associated with a 2 fold higher risk of death. 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. Stunting (Short stature)was defined as height below - 2 standard deviations from the median of the NCHS reference heights for 18 year old men and women[31], as has been done in some other studies on nutritional status from India[32]. Variables were included in the final model if the univariate analysis showed a p value < 0.25, or if the variable was of known clinical importance[33].

We conducted a sensitivity analysis assuming a mortality rate of 15% in defaulters (documented in a recent cohort study)[53]. Anti-TB drugs were provided at highly subsidised rates ($ 1 per month) or were free. Only 2.4% of patients had pre-treatment weights equal to or above the suggested Indian reference weights[30].

However, there is strong evidence that proper nutritional care improves nutritional recovery for people who are undernourished, and therefore helps reduce general health risks. Of these patients, measurements of body weight and height at diagnosis were made in 1665 (98.2%) and 1523 (89.9%) respectively. Association between categorical variables was assessed using the Fisher’s exact test. p=0.03).

Patients who opted for treatment at JSS received daily, self-administered, short course therapy prescribed according to WHO Guidelines[26]. Low BMI has been reported as an independent risk factor for all cause and TB related mortality in population based cohorts [42–44]. However, data from India are sparse, despite the high burden of TB as well as malnutrition in India. Under-nutrition is a known risk factor for TB and can adversely affect treatment outcomes. 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.

Latent TB Infection Resources. of patients with pulmonary TB & Diabetes mellitus,(%) of tested, No. Yes Information on age, gender, residence, sputum smear status, grade of sputum smear, previous history of treatment, history of any illness or death in a family member diagnosed as TB, was recorded for each patient.

Demographic, clinical, and anthropometric characteristics of all adult patients diagnosed with pulmonary tuberculosis at JSS (2004-2009). lab icon. In patients where both heights and weights were obtained, body mass index (BMI in kg/m2) was calculated and the patients were classified into categories based on the BMI cut-offs for weight categories as recommended by the WHO [28,29].

Nutrition assessment and management are key components of TB treatment 4.