Undernutrition and Mortality among Adult Tuberculosis Patients in Addis Ababa, Ethiopia.

Advances in Preventive Medicine Pub Date : 2020-07-27 eCollection Date: 2020-01-01 DOI:10.1155/2020/5238010
Getachew Seid, Marta Ayele
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引用次数: 10

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.

Abstract Image

Abstract Image

埃塞俄比亚亚的斯亚贝巴成年结核病患者的营养不良和死亡率。
背景:在发展中国家,有一些成人结核病(TB)患者严重营养不良。营养不良是患肺结核的一个重要危险因素。在世界上,结核病是十大主要死亡原因之一。为了适当干预成人结核病患者的死亡,了解其中营养不良的程度及其相关因素至关重要。该研究评估了埃塞俄比亚亚的斯亚贝巴成年结核病患者的营养不良和死亡率。方法:2019年1月至2019年8月在埃塞俄比亚亚的斯亚贝巴进行了基于机构的回顾性研究。该研究的总样本量为284。源人群为在亚的斯亚贝巴公共卫生设施接受结核病治疗的结核病患者。样本量被分配到与其规模成比例的选定卫生机构,研究对象在研究期间被纳入研究。数据通过选定的医疗中心登记簿中的结构化数据表收集。数据录入Epi Data软件,使用SPSS 20进行分析。描述性统计方法用于总结研究参与者的社会人口学特征。使用Kaplan-Meier法生成所有结核病患者的生存曲线。结果:共纳入284名研究对象。结果发现,46.8%的研究人群在登记接受治疗时存在营养不良(BMI 2)。在营养不良患者中,54例(19.0%)为重度营养不良,78例(27.5%)为中度营养不良。在两个月的强化治疗期结束时,营养不良发生率下降到38.7%。284例患者中,17例(6.0%)在完成抗结核治疗前死亡。在所有形式的结核病死亡中,有四分之三发生在抗结核治疗开始后的57天内。正常、中度急性营养不良和严重急性营养不良结核病患者在治疗开始时按营养状况划分的死亡比例分别为3.1%、8.9%和16.3%。结论:在基于BMI的抗结核治疗开始时,几乎有一半的结核病患者营养不良。在两个月的强化治疗期结束时,从营养不良的参与者中,只有不到20%的人体重增加并恢复到正常体重。据报道,严重营养不良结核病患者的死亡率很高,但需要更大规模的研究来进一步了解预测因素。为了提高治疗期间的营养状况,政府应重视支持结核病患者的营养补充。
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