Under-nutrition among adult tuberculosis patients completing intensive-phase treatment at public health facilities in Kembata Zone, Central Ethiopia Region.

BACKGROUND

Nutritional impacts of tuberculosis (TB) have long been recognised. According to the national TB treatment guidelines, individuals with TB are assessed for under-nutrition during treatment initiation and receive regular nutritional counselling and support, including food supplementation, when the condition is detected. However, the extent of under-nutrition after completing intensive-phase of treatment, which may indicate its potential persistence, remains unclear especially in resource-limited settings.

OBJECTIVE

This study aimed to assess the extent of under-nutrition and associated factors among adult TB patients completing intensive-phase treatment at public health facilities of Kembata Zone, Central Ethiopia Region.

METHODS

We conducted a cross sectional facility-based study among 334 adult TB patients in the continuous-phase treatment. Participants were recruited using a cluster sampling technique. Bivariate logistic regression analysis was performed to assess the association between under-nutrition and explanatory variables. Odds ratios along with 95% confidence interval (CI) were estimated to identify factors significantly associated with under-nutrition using multivariable logistic regression analysis. The level of statistical significance was determined at P-value less than 0.05.

RESULTS

Under-nutrition was detected in almost 19% of participants. Sociodemographic and clinical factors contributed to the presence of under-nutrition in the continuous-phase of treatment. Not attending formal education (AOR: 4.2; 95%CI: 1.7–10.4) and living in a family of more than five (AOR: 2.3; 95%CI: 1.2–4.6) were sociodemogrphic factors associated with the occurrence of under-nutrition. Having extra-pulmonary TB (EPTB) (AOR: 3.2; 95%CI: 1.4–7.6) and shorter length (less than four months) of treatment (AOR: 4.3; 95%CI: 1.9–9.5) were clinical conditions linked with under-nutrition.

CONCLUSIONS

Our study identified a higher prevalence of under-nutrition in the continuous-phase of TB treatment than the targets of clinical guidelines, which expect optimal nutritional status in all patients. This may suggest potential persistence of poor nutritional status (or a lack of weight gain) from the earlier period of treatment. This may reflect lower understandings of the nutritional impact of TB in association with a lack of formal education, and a limited adequate diet due to a larger family size. Being in the earlier period of continuous-phase treatment and having EPTB also increased the likelihood of under-nutrition. Continuous monitoring and support is suggested throughout the treatment course with a particular focus on individuals with a lower socioeconomic background and EPTB.