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

SETTINGS: All sputum microscopy laboratories under the BRAC Tuberculosis Programme in Dhaka City.

OBJECTIVES

To study the nutritional status of tuberculosis (TB) patients attending microscopy laboratories during convalescence following DOTS.

DESIGN

The study included 1068 TB patients registered for treatment at 10 laboratories from May 2010 to December 2011, and 910 healthy neighbourhood controls. Weight (in kg), height (in cm) and mid-upper arm circumference (MUAC; in cm) were measured before, at 2 months and immediately after completion of treatment. Body mass index (BMI) < 18.5 kg/m(2) and MUAC < 22.0 cm were taken as cut-offs for defining malnourishment.

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 DOTS-based treatment.