Prevalence and factors associated with malnutrition among adult Tuberculosis patients attending the national referral tuberculosis program clinic at Mulago Hospital

Abstract

Malnutrition is the major cause of morbidity for all age groups, accounting for 11 percent of the disease burden globally. According to the Uganda Demographic and Health Survey (UDHS), 19 percent of the Ugandan population was malnourished in 2006, and among women of reproductive age, more than 12 percent were found to be underweight in 2006, with a body mass index (BMI) of less than 18.5 kg/m2. Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world. Tuberculosis can lead to or worsen pre-existing under-nutrition, by decreasing appetite, and by increased catabolism. There are few published studies on malnutrition assessment and malnutrition in tuberculosis patients seems to be obvious but its burden has not been documented in Uganda. Objective This study aimed at determining the prevalence and factors associated with malnutrition among newly diagnosed tuberculosis patients attending the national referral tuberculosis program clinic in Mulago hospital. Methods This was a cross-sectional study using quantitative methods of data collection and analysis. A total of 415 newly diagnosed tuberculosis patients aged 18years and above who attended the national referral tuberculosis program clinic at Mulago hospital during the study period, willing and able to give informed consent were included in the study. Patients were enrolled consecutively. Prevalence was calculated by dividing the number of patients found to be malnourished with the total number of patients enrolled. Poisson regression was conducted using STATA V.12 for bivariate and multivariate analysis to determine the significant factors associated with malnutrition in tuberculosis patients. Assessment for interaction and confounding was done. Results The prevalence of malnutrition reported 46.0% (191 patients) 95% CI (41.3%, 50.8%). There was significant association between HIV status: HIV positive (PR=1.54, 95% CI 1.214, and 1.949), unknown status (PR=2.05, 95% CI 1.41, and 2.98) and number of meals a day (PR=1.29, 95% CI 1.03, and 1.61) Conclusion The prevalence of malnutrition in tuberculosis patients attending the national referral program clinic in Mulago hospital was high. HIV status and number of meals a day were significantly associated with malnutrition in tuberculosis patients. The MoH should consider Body mass index (BMI) as a screening criteria for TB medication dosage and capture it in the tuberculosis patients registers to assess the nutritional status of patients. The National Tuberculosis Programme should consider adjunctive nutritional support as rational step in the efforts towards optimizing current management of tuberculosis patients