Effect of Nutritional Support on Treatment of Multi-Drug Resistant Tuberculosis in Rajshahi Division, 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 2) 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 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.