Effect of Nutritional Support on Treatment of Multi-Drug Resistant Tuberculosis in Rajshahi Division, Bangladesh ()
Affiliation(s)
1Institute of Biological Sciences, University of Rajshahi, Rajshahi, Bangladesh.
2Department of Statistics, University of Rajshahi, Rajshahi, Bangladesh.
3Department of Public Health, James P. Grant School of Public Health, Dhaka, Bangladesh.
4Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh.
ABSTRACT
Introduction: Multi-drug resistant tuberculosis (MDR-TB) is a
public health crisis throughout the world including Bangladesh
particularly due to its complexities in diagnosis, longer treatment regimen,
and adverse drug reaction. Nutritional supplementation has significant impact
on patient’s weigh gain and optimum weight gain is a biomarker of treatment
response. The objective of this study was
to measure body mass index (BMI) progress among MDR-TB patients in
different phases of treatment. Methodology: A
prospective observational study was conducted from March 2010 to July 2015 in
Chest Disease Hospital (CDH), Rajshahi and different communities of Rajshahi
Division, Bangladesh. A total of 233 confirmed MDR-TB patients were selected
from CDH who received treatment and nutritional support from ongoing national
TB control program (NTP). They received free diagnosis, follow up tests,
treatment and nutritional support as regular diet as well as cash amount Bangladeshi
taka (BDT.) 1000
per month in CDH. Along with treatment, they also received only cash amount BDT. 1500 per month as
nutritional support at community level. Weight measurement was taken at regular
interval from enrollment to completion of treatment. Chi-square, paired t-test
and linear regression analysis were used in this study. Results:
The baseline prevalence of undernourished (BMI < 18.5 kg/m2) was
82.4%. After two months of treatment, 14.5% underweight patients gained weight
and reverted to normal BMI. Regression analysis showed the decreasing tendency
of BMI progress with increasing age which was significant among male patients
(p < 0.05). We observed reversely that patients gained more BMI in intensive
phase than continuation phase of treatment. The cohort results demonstrated
that the treatment success rate was lower (<83%) among initially underweight
patients than their counterparts (>92%). Conclusion: Nutritional
support has synergistic effect on treatment response. Adequate nutritional
support with proper treatment would help to get better outcomes particularly at
community level. Gender issue should also be addressed at household level.
Share and Cite:
Sayem, M. , Hossain, M. , Ahmed, T. , Hossain, K. and Saud, Z. (2020) Effect of Nutritional Support on Treatment of Multi-Drug Resistant Tuberculosis in Rajshahi Division, Bangladesh.
Journal of Tuberculosis Research,
8, 223-236. doi:
10.4236/jtr.2020.84020.