Nutritional supplements for people being treated for active tuberculosis

Multidrug-resistant tuberculosis (MDR TB) IntroductionThe significant threat of the global multidrug-resistant tuberculosis (MDR TB) epidemic has been described as a crisis in the World Health Organization's (WHO's) End TB strategy .1 MDR TB is defined as tuberculosis (TB) caused by Mycobacterium tuberculosis isolates that are resistant to at least both rifampicin and isoniazid.2 The WHO's Global tuberculosis report supplement in 2014 estimated that MDR TB accounts for 3.5% (95% confidence interval (CI) 2.2-4.7%) of all new cases of TB and 20.5% (95% CI 13.6-27.5%) of TB cases among individuals previously treated for the disease. 3 There were approximately 480,000 new cases of MDR TB globally in 2013, with an estimated 210,000 deaths attributable to MDR TB. The highest levels of MDR TB are in Eastern European and Asian countries, with more than half the global burden of MDR TB being located in India, China and Russia. 4 Additional cause for concern is the emergence of extensively drug-resistant TB (XDR TB), which is defined as tuberculosis caused by M tuberculosis isolates that are resistant to rifampicin, isoniazid, any ABSTRACT fluoroquinolones and at least one of the second-line injectable drugs (capreomycin, kanamycin and amikacin). Here we provide an overview of the importance of MDR TB, its epidemiology, clinical implications, potential ways of addressing the disease and prospects for new diagnostics and treatment. EpidemiologyGlobal epidemiology of TB

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“…8 This includes administering vitamin B6 (pyridoxine) in all MDR TB patients who are receiving isoniazid, linezolid, cycloserine or terizidone.…”

Section: Nutritional Supportmentioning

confidence: 99%

Clinical implications of the global multidrug-resistant tuberculosis epidemic

Kumar

Abubakar

2016

Clinical Medicine

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“…4,6,7 While there is not enough evidence that nutritional support can improve TB treatment response and outcomes, there is evidence to suggest that it can improve nutritional rehabilitation in persons with TB. 8 Food supplementation has been found to improve body weight and quality of life of TB patients, 9 and accelerate the benefi cial therapeutic effect of chemotherapy. 10,11 Demand for the integration of nutritional interventions into TB control programmes is increasing, particularly in countries with a AFFILIATIONS…”

Section: Discussionmentioning

confidence: 99%

Beyond drugs: tuberculosis patients in Bangladesh need nutritional support during convalescence

Islam

Ahmed

Islam

et al. 2013

public health action

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high TB burden. 2,6,12 The effective management of TB therefore requires a detailed evaluation of nutritional status, as this can help to prevent or modify many complications of the disease.Signifi cant improvement has been achieved in TB control in Bangladesh in the last few years. 13 The government of Bangladesh, in partnership with different non-government organisations, including BRAC, has been implementing a community-based National Tuberculosis Control Programme (NTP) based on the DOTS strategy since 1993. 14 As data on the nutritional status of TB patients are scarce and unreliable in Bangladesh, the BRAC Research and Evaluation Division (RED) initiated a study to explore the nutritional status of TB patients attending peri-urban BRAC sputum microscopy laboratories during the various stages of convalescence before, at 2 months and immediately after completion of DOTS-based treatment.The present study will help fi ll in this gap in knowledge and help design programme interventions for better management of nutrition for TB patients in the country. METHODS Study settingsThe study was conducted among TB patients from peri-urban populations registered for treatment at BRAC TB sputum microscopy laboratories in Dhaka City. Patients with cough of >3 weeks' duration attend the microscopy laboratories for sputum testing free of charge under the NTP. Smear-positive pulmonary TB cases are registered immediately for treatment. Patients with negative microscopy results undergo further investigations and, if found positive, are admitted for treatment at the BRAC laboratory. Study population and sample sizeWe included 1110 new TB patients aged >15 years registered at 10 BRAC sputum microscopy laboratories from May 2010 to December 2011. Of these, 42 were excluded (3.9%) as they were not available for interview, had a previous history of TB, were receiving anti-t uberculosis treatment, were pregnant or currently lactating, had diabetes mellitus or had any form of mental disease, as confi rmed by physicians. Healthy controls (comparison group) were selected from nonfamily neighbours of the patients (same socio-economic status), and were matched by age and sex with TB patients (one for each TB case). Around 12% of the controls did not agree to provide information or participate. A fi nal sample of 1068 TB patients (624 males Results: Two thirds of the patients (67%) had a low BMI (<18.5 kg/m 2 ) before treatment, compared to only 23% among the healthy controls. At the end of treatment, 50% of the patients still had a low BMI, including 12% who had severe malnourishment (BMI ⩽ 16 kg/m 2 ). MUAC < 22.0 cm was higher among patients before (42%), at 2 months (39%) and immediately after completion of treatment (34%) compared to the control group (9%). Conclusions:Malnutrition is a serious problem among TB patients in peri-urban areas of Dhaka City. Under the circumstances, additional nutritional supplements, combined with education on nutrition, are expected to contribute to rapid and sustained recovery during DOTSbased treatmen...

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“…A nivel de programa, los hallazgos informan sobre qué grupos podrían ser priorizados con la finalidad de maximizar los resultados, en el plano nutricional, sobre todo cuando el beneficio de incentivos nutricionales sobre la adherencia o el estado nutricional no es del todo claro (5) .…”

Section: Discussionunclassified

“…El objetivo principal del programa es contribuir a la recuperación integral del paciente ambulatorio afectado de TB, y a la protección de su familia mediante actividades de educación, evaluación nutricional y complementación alimentaria con una canasta de alimentos que brinde el 28% de los requerimientos calóricos y el 38% de los requerimientos proteicos de la familia (un paciente y dos contactos) (3,4) . La experiencia de proveer soporte nutricional para esta enfermedad se ha dado en varias regiones a nivel mundial y aunque sus beneficios no son del todo claros, puede servir como incentivo para promover la adherencia al tratamiento médico (5) .…”

Section: Introductionunclassified

Variación del estado nutricional durante el tratamiento antituberculoso en beneficiarios del programa PANTBC

Aparco

Huamán-Espino

Segura

2012

Rev Peru Med Exp Salud Publica

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RESUMENObjetivos. Analizar la variación nutricional de los beneficiarios actuales y pasados del Programa de Alimentación y Nutrición al Paciente Ambulatorio con Tuberculosis y Familia (PANTBC). Materiales y métodos. Se realizó un análi-sis secundario a partir de la valoración antropométrica por medio del índice de masa corporal (IMC) en beneficiarios actuales y pasados del programa PANTBC. Las mediciones se realizaron al inicio, segundo y quinto o sexto mes y se comparó la distribución del estado nutricional al inicio respecto al final (prueba de McNemar-Bowker). Resultados. Se incluyó información de 409 beneficiarios actuales y 110 beneficiarios pasados. Tanto en beneficiarios actuales como pasados se observó disminución progresiva de la condición de bajo peso (IMC<18,5) así como el aumento de la condición de sobrepeso. Los resultados de la tercera medición mostraron que el 57,7% de los beneficiarios actuales que iniciaron con bajo peso terminaron con peso normal, mientras el 20,7% de los que iniciaron con peso normal terminaron con sobrepeso. La comparación del estado nutricional al inicio respecto al final mostró cambios en la distribución (p<0,05). Conclusiones. A lo largo del programa PANTBC existe variación del estado nutricional de los beneficiarios, con la tendencia de pasar de un nivel inferior a otro superior de IMC. Palabras clave: Tuberculosis; Estado nutricional; Índice de masa corporal (fuente: DeCS BIREME). CHANGE IN NUTRITIONAL STATUS OVER THE COURSE OF ANTITUBERCULOSIS TREATMENT IN CURRENT AND PAST BENEFICIARIES OF THE PROGRAM PANTBC ABSTRACT Objectives. Analyze the nutritional changes among current and old beneficiaries of the Food and Nutrition Program for Outpatients with Tuberculosis and their Family (PANTBC, Spanish acronym). Materials and methods.A secondary analysis was conducted based on the anthropometric measurements with the body mass index (BMI) in current and old beneficiaries of the PANTBC program. The measurements were taken at the baseline, second and fifth or sixth month, and the distribution of the nutritional status was analyzed at baseline as compared to the endpoint (McNemar-Bowker test). Results. Information about 409 current beneficiaries and 110 old beneficiaries were included. A progressive decline in low weight as well as an increase in overweight were observed in both current and old beneficiaries (IMC<18.5). The results of the third measurement showed that 57.7% of current beneficiaries who started with low weight ended up with normal weight, while 20.7% of those who started with normal weight ended up with overweight. The analysis of the nutritional status at baseline compared to the endpoint showed changes in distribution (p<0.05). Conclusions. Across the PANTBC program, there is a variation of beneficiaries' nutritional status, showing a tendency to go from a lower level to a higher level of BMI.

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Nutritional supplements for people being treated for active tuberculosis

Abstract: Nutritional supplements for people being treated for active tuberculosis.

Cited by 95 publications

References 44 publications

Clinical implications of the global multidrug-resistant tuberculosis epidemic

Clinical implications of the global multidrug-resistant tuberculosis epidemic

Beyond drugs: tuberculosis patients in Bangladesh need nutritional support during convalescence

Variación del estado nutricional durante el tratamiento antituberculoso en beneficiarios del programa PANTBC

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