Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania
Identifieur interne : 003C11 ( Main/Exploration ); précédent : 003C10; suivant : 003C12Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania
Auteurs : Kosuke Kawai [États-Unis] ; Eduardo Villamor [États-Unis] ; Ferdinand M. Mugusi [Tanzanie] ; Elmar Saathoff [Allemagne] ; Willy Urassa [Tanzanie] ; Ronald J. Bosch [États-Unis] ; Donna Spiegelman [États-Unis] ; Wafaie W. Fawzi [États-Unis]Source :
- The International Journal of Tuberculosis and Lung Disease [ 1027-3719 ] ; 2011.
Abstract
Patients with tuberculosis (TB) often suffer from profound malnutrition.
To examine the patterns and predictors of change in nutritional and hemoglobin status during and after TB treatment.
A total of 471 HIV-positive and 416 HIV-negative adults with pulmonary TB were prospectively followed in Dar es Salaam, Tanzania. All patients received 8 months TB treatment following enrollment.
About 40% of HIV-positive and 47% of HIV-negative TB patients had BMI <18.5 kg/m2 at baseline. About 94% of HIV-positive and 84% of HIV-negative participants were anemic at baseline. Both HIV-positive and HIV-negative patients experienced increases in BMI and hemoglobin concentrations over the course of TB treatment. Among HIV-positive patients, older age, low CD4 cell counts, and high viral load were independently associated with a smaller increase in BMI from baseline to 8 months. Female sex, older age, low CD4 cell counts, previous TB infection, and less money spent on food were independently associated with a smaller improvement in hemoglobin among HIV-positive patients during treatment.
HIV- positive TB patients, especially those with low CD4 cell counts, showed poor nutritional recovery during TB treatment. Adequate nutritional support should be considered during TB treatment.
Url:
DOI: 10.5588/ijtld.10.0784
PubMed: 22283899
PubMed Central: 3404808
Affiliations:
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Mugusi</name><affiliation wicri:level="1"><nlm:aff id="A7">Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Saathoff, Elmar" sort="Saathoff, Elmar" uniqKey="Saathoff E" first="Elmar" last="Saathoff">Elmar Saathoff</name><affiliation wicri:level="1"><nlm:aff id="A9">Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU), Germany</nlm:aff><country xml:lang="fr">Allemagne</country><wicri:regionArea>Division of Infectious Diseases and Tropical Medicine, Medical Center of the University of Munich (LMU)</wicri:regionArea><wicri:noRegion>Medical Center of the University of Munich (LMU)</wicri:noRegion><wicri:noRegion>Medical Center of the University of Munich (LMU)</wicri:noRegion><wicri:noRegion>Medical Center of the University of Munich (LMU)</wicri:noRegion></affiliation></author><author><name sortKey="Urassa, Willy" sort="Urassa, Willy" uniqKey="Urassa W" first="Willy" last="Urassa">Willy Urassa</name><affiliation wicri:level="1"><nlm:aff id="A8">Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff><country xml:lang="fr">Tanzanie</country><wicri:regionArea>Department of Microbiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam</wicri:regionArea><wicri:noRegion>Dar es Salaam</wicri:noRegion></affiliation></author><author><name sortKey="Bosch, Ronald J" sort="Bosch, Ronald J" uniqKey="Bosch R" first="Ronald J" last="Bosch">Ronald J. Bosch</name><affiliation wicri:level="2"><nlm:aff id="A3">Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Harvard School of Public Health, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="A5">Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Spiegelman, Donna" sort="Spiegelman, Donna" uniqKey="Spiegelman D" first="Donna" last="Spiegelman">Donna Spiegelman</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, Harvard School of Public Health, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="A3">Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Biostatistics, Harvard School of Public Health, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author><author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W" last="Fawzi">Wafaie W. Fawzi</name><affiliation wicri:level="2"><nlm:aff id="A1">Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Epidemiology, Harvard School of Public Health, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="A2">Department of Nutrition, Harvard School of Public Health, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Nutrition, Harvard School of Public Health, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation><affiliation wicri:level="2"><nlm:aff id="A4">Department of Global Health and Population, Harvard School of Public Health, Boston, MA, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Department of Global Health and Population, Harvard School of Public Health, Boston, MA</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j">The International Journal of Tuberculosis and Lung Disease</title><idno type="ISSN">1027-3719</idno><idno type="eISSN">1815-7920</idno><imprint><date when="2011">2011</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>BACKGROUND</title><p id="P1">Patients with tuberculosis (TB) often suffer from profound malnutrition.</p></sec><sec id="S2"><title>OBJECTIVE</title><p id="P2">To examine the patterns and predictors of change in nutritional and hemoglobin status during and after TB treatment.</p></sec><sec id="S3"><title>METHODS</title><p id="P3">A total of 471 HIV-positive and 416 HIV-negative adults with pulmonary TB were prospectively followed in Dar es Salaam, Tanzania. All patients received 8 months TB treatment following enrollment.</p></sec><sec id="S4"><title>RESULTS</title><p id="P4">About 40% of HIV-positive and 47% of HIV-negative TB patients had BMI <18.5 kg/m<sup>2</sup> at baseline. About 94% of HIV-positive and 84% of HIV-negative participants were anemic at baseline. Both HIV-positive and HIV-negative patients experienced increases in BMI and hemoglobin concentrations over the course of TB treatment. Among HIV-positive patients, older age, low CD4 cell counts, and high viral load were independently associated with a smaller increase in BMI from baseline to 8 months. Female sex, older age, low CD4 cell counts, previous TB infection, and less money spent on food were independently associated with a smaller improvement in hemoglobin among HIV-positive patients during treatment.</p></sec><sec id="S5"><title>CONCLUSION</title><p id="P5">HIV- positive TB patients, especially those with low CD4 cell counts, showed poor nutritional recovery during TB treatment. Adequate nutritional support should be considered during TB treatment.</p></sec></div></front></TEI><affiliations><list><country><li>Allemagne</li><li>Tanzanie</li><li>États-Unis</li></country><region><li>Massachusetts</li><li>Michigan</li></region></list><tree><country name="États-Unis"><region name="Massachusetts"><name sortKey="Kawai, Kosuke" sort="Kawai, Kosuke" uniqKey="Kawai K" first="Kosuke" last="Kawai">Kosuke Kawai</name></region><name sortKey="Bosch, Ronald J" sort="Bosch, Ronald J" uniqKey="Bosch R" first="Ronald J" last="Bosch">Ronald J. Bosch</name><name sortKey="Bosch, Ronald J" sort="Bosch, Ronald J" uniqKey="Bosch R" first="Ronald J" last="Bosch">Ronald J. Bosch</name><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W" last="Fawzi">Wafaie W. Fawzi</name><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W" last="Fawzi">Wafaie W. Fawzi</name><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W" last="Fawzi">Wafaie W. Fawzi</name><name sortKey="Spiegelman, Donna" sort="Spiegelman, Donna" uniqKey="Spiegelman D" first="Donna" last="Spiegelman">Donna Spiegelman</name><name sortKey="Spiegelman, Donna" sort="Spiegelman, Donna" uniqKey="Spiegelman D" first="Donna" last="Spiegelman">Donna Spiegelman</name><name sortKey="Villamor, Eduardo" sort="Villamor, Eduardo" uniqKey="Villamor E" first="Eduardo" last="Villamor">Eduardo Villamor</name><name sortKey="Villamor, Eduardo" sort="Villamor, Eduardo" uniqKey="Villamor E" first="Eduardo" last="Villamor">Eduardo Villamor</name><name sortKey="Villamor, Eduardo" sort="Villamor, Eduardo" uniqKey="Villamor E" first="Eduardo" last="Villamor">Eduardo Villamor</name></country><country name="Tanzanie"><noRegion><name sortKey="Mugusi, Ferdinand M" sort="Mugusi, Ferdinand M" uniqKey="Mugusi F" first="Ferdinand M" last="Mugusi">Ferdinand M. Mugusi</name></noRegion><name sortKey="Urassa, Willy" sort="Urassa, Willy" uniqKey="Urassa W" first="Willy" last="Urassa">Willy Urassa</name></country><country name="Allemagne"><noRegion><name sortKey="Saathoff, Elmar" sort="Saathoff, Elmar" uniqKey="Saathoff E" first="Elmar" last="Saathoff">Elmar Saathoff</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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