Nutritional status of adolescents undergoing tuberculosis treatment in urban Bangladesh: prevalence and determinants of malnutrition.

Abstract

Objectives: Tuberculosis is a global public health challenge, disproportionately affecting adolescents in low-and middle-income countries. Malnutrition worsens immune function, delays recovery and increases the risk of treatment failure in Tuberculosis patients. The objectives of this study was to assess the nutritional status of adolescents undergoing TB treatment in urban Bangladesh and identify the determinants of malnutrition.

Methods: A cross-sectional study was conducted from November 1, 2023, to May 31, 2024, among 339 adolescents receiving Tuberculosis treatment in five hospitals in Dhaka, Bangladesh. Nutritional status was primarily assessed by Patient-Generated Subjective Global Assessment (PG-SGA). Anthropometric data were collected to calculate BMI-for-age and height-for-age z-scores to verify nutritional status.

Results: The prevalence of severe malnutrition was 14.2 % and another 41.6 % were found moderately malnourished in PG-SGA. The z-scores also showed 14.2 % had severe malnutrition and 21.2 % had moderate malnutrition. The mean BMI was 17.89, with 59.3 % of participants underweight and 63.7 % experiencing some degree of stunting. Eating difficulties, particularly appetite loss, were reported by 45.4 % of adolescents. While 52.8 % received some nutrition-related information, only 1.8 % received comprehensive nutritional care. Logistic regression identified significant predictors of malnutrition, including female gender (AOR=0.51, p=0.01), presence of major comorbidities (AOR=3.67, p=0.01), eating difficulties (AOR=3.41, p<0.01), Type I Tuberculosis (AOR=2.57, p<0.01), and less than four meals (AOR=2.69, p=0.01).

Conclusions: Both PG-SGA and anthropometric indicators revealed significant nutritional deficits. Integrated nutritional support and management of comorbidities should be prioritized alongside Tuberculosis care to improve treatment outcomes.