Journal
TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE
Volume 105, Issue 3, Pages 140-147Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.trstmh.2010.11.009
Keywords
pulmonary tuberculosis; HIV; weight; body composition; nutritional status; handgrip strength
Funding
- Danish Council for Independent Research - Medical Sciences [22-04-0404]
- Danida through the Consultative Research Committee for Development Research [104.Dan.8-898]
- University of Copenhagen through the Cluster in International Health
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This study aimed to estimate deficits in weight, arm fat area (AFA), arm muscle area (AMA) and handgrip strength among smear-positive pulmonary TB (PTB+) patients starting treatment. We conducted a cross-sectional study among PTB+ patients and age- and sex-matched neighborhood controls. HIV status, anthropometric measurements and handgrip strength were determined. Deficits in weight, AFA, AMA and handgrip strength associated with PTB+ and HIV were estimated using multiple regression analysis. We recruited 355 pairs of PTB+ patients and controls. PTB+ was associated with deficits of 10.0 kg (95% CI 7.3; 12.7) in weight and 6.8 kg (95% CI 5.2; 8.3) in handgrip strength among females and 9.1 kg (95% CI 7.3; 10.9) in weight and 6.8 kg (95% CI 5.2; 8.4) in handgrip strength among males. In both sexes, PTB+ was associated with deficits in AFA and AMA. Among females, HIV was associated with deficits in AMA and handgrip strength, but the deficit in handgrip strength was larger among PTB+ patients (3.2 kg 95% CI 1.3; 5.2) than controls (-1.6 kg 95% CI -4.8; 1.5) (interaction, P=0.009). These findings suggest that deficits in weight and handgrip strength among patients starting TB treatment are severe. Thus, nutritional support may be necessary to ensure reversal of the deficits, and may improve treatment outcomes. (C) 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.
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