Effects of body weight changes on Treatment Outcomes among Multidrug-Resistant Tuberculosis Patients in Peshawar
Keywords:
MDR-TB, Body Weight, Nutritional Status, Treatment OutcomesAbstract
 Background: Multidrug-resistant tuberculosis (MDR-TB) is a major global health concern, particularly in low-resource settings such as Peshawar, Pakistan. Nutritional status, reflected by body weight changes during treatment, is a critical factor influencing treatment outcomes. Objective: This study examines the relationship between body weight changes and MDR-TB treatment outcomes to inform targeted interventions. Methodology: A retrospective cohort study was conducted among 185 MDR-TB patients undergoing treatment in Peshawar. Patients were categorized based on weight changes during treatment: weight gain (>5%), stable weight, and weight loss (<5%). Final treatment outcomes were analyzed across these categories. Results: Patients with weight gain ≥5 kg (32.4%) showed the highest treatment success rate (90.0%), with minimal failure (6.7%) and default (3.3%). Patients with weight gain 2–4.9 kg (21.6%) had a success rate of 80.0%, with failure and default rates of 15.0% and 5.0%, respectively. Stable weight (18.9%) was associated with a success rate of 68.6%, and higher failure (20.0%) and default (11.4%) rates. Weight loss 2–4.9 kg (16.2%) and ≥5 kg (10.8%) showed significantly poorer outcomes, with success rates of 50.0% and 40.0%, failure rates of 26.7% and 45.0%, and default rates of 23.3% and 15.0%, respectively. Conclusion: Body weight changes significantly influence MDR-TB treatment outcomes. Weight gain during treatment is associated with improved recovery, while weight loss predicts higher rates of failure and mortality. Nutritional support should be integrated into MDR-TB treatment protocols to enhance outcomes, particularly in resource-limited settings like Peshawar.References
Khan MA, Mehreen S, Basit A, Khan RA, Jan F, Ullah I, et al. Characteristics and treatment outcomes of patients with multi-drug resistant tuberculosis at a tertiary care hospital in Peshawar, Pakistan. Saudi Med J. 2015;36(12):1463.
Migliori GB, Tiberi S, Zumla A, Petersen E, Chakaya JM, Wejse C, et al. MDR/XDR-TB management of patients and contacts: Challenges facing the new decade. The 2020 clinical update by the Global Tuberculosis Network. Int J Infect Dis. 2020;92:S15-25.
Lönnroth K, Williams BG, Cegielski P, Dye C. A consistent log-linear relationship between tuberculosis incidence and body mass index. Int J Epidemiol. 2010;39(1):149-55.
Khan MA, Mehreen S, Basit A, Khan RA, Javaid A. Predictors of poor outcomes among patients treated for multidrug-resistant tuberculosis at a tertiary care hospital in Pakistan. Am Eurasian J Toxicol Sci. 2015;7(3):162-72.
World Health Organization. Compendium of WHO guidelines and associated standards: ensuring optimum delivery of the cascade of care for patients with tuberculosis. World Health Organization; 2018.
Javaid A, Khan MA, Jan F, Rauf M, Khan MA, Basit A, Mehreen S. Occurrence of adverse events in patients receiving community-based therapy for multidrug-resistant tuberculosis in Pakistan. Tuberk Toraks. 2018;66(1):16-25.
Putri FA, Burhan E, Nawas A, Soepandi PZ, Sutoyo DK, Agustin H, et al. Body mass index predictive of sputum culture conversion among MDR-TB patients in Indonesia. Int J Tuberc Lung Dis. 2014;18(5):564-70.
Bernabe-Ortiz A, Carcamo CP, Sanchez JF, Rios J. Weight variation over time and its association with tuberculosis treatment outcome: a longitudinal analysis. PLoS One. 2011;6(4):e18474.
Filate M, Mehari Z, Alemu YM. Longitudinal body weight and sputum conversion in patients with tuberculosis, Southwest Ethiopia: a retrospective follow-up study. BMJ Open. 2018;8(9):e019076.
Park HO, Kim SH, Moon SH, Byun JH, Kim JW, Lee CE, et al. Association between body mass index and sputum culture conversion among South Korean patients with multidrug-resistant tuberculosis in a tuberculosis referral hospital. Infect Chemother. 2016;48(4):317-23.
Sultan KM, Alobaidy MW, AL-Jubouri AM, Naser AA, AL-Sabah HA. Assessment of body mass index and nutritional status in pulmonary tuberculosis patients. J Fac Med Baghdad. 2012;54(3):204-8.
Rohini K, Bhat S, Srikumar PS, Saxena J, Kumar MA. Body weight gain in pulmonary tuberculosis during chemotherapy. Int J Collab Res Intern Med Public Health. 2013;5(4):247.
Hanrahan CF, Golub JE, Mohapi L, Tshabangu N, Modisenyane T, Chaisson RE, et al. Body mass index and risk of tuberculosis and death. AIDS. 2010;24(10):1501-8.
Chen J, Zha S, Hou J, Lu K, Qiu Y, Yang R, Li L, Yang Y, Xu L. Dose–response relationship between body mass index and tuberculosis in China: a population-based cohort study. BMJ Open. 2022;12(3):e050928.
Manasa D, Lalitha K, Ram A, Shivaraj NS. Weight changes and its determinants among sputum-positive pulmonary TB patients in Bengaluru: a prospective study. RGUHS Natl J Public Health. 2022;7(1).
PrayGod G, Range N, Faurholt-Jepsen D, Jeremiah K, Faurholt-Jepsen M, Aabye MG, et al. Weight, body composition and handgrip strength among pulmonary tuberculosis patients: a matched cross-sectional study in Mwanza, Tanzania. Trans R Soc Trop Med Hyg. 2011;105(3):140-7.
Bhargava A, Bhargava M, Meher A, Benedetti A, Velayutham B, Teja GS, et al. Nutritional supplementation to prevent tuberculosis incidence in household contacts of patients with pulmonary tuberculosis in India (RATIONS): a field-based, open-label, cluster-randomised, controlled trial. Lancet. 2023;402(10402):627-40.
Hoa NB, Lauritsen JM, Rieder HL. Changes in body weight and tuberculosis treatment outcome in Viet Nam. Int J Tuberc Lung Dis. 2013;17(1):61-6.
Banu S, Hossain A, Uddin MK, Uddin MR, Ahmed T, Khatun R, Mahmud AM, et al. Pulmonary tuberculosis and drug resistance in Dhaka central jail, the largest prison in Bangladesh. PLoS One. 2010;5(5):e10759.
Wagnew F, Alene KA, Kelly M, Gray D. Impacts of body weight change on treatment outcomes in patients with multidrug-resistant tuberculosis in Northwest Ethiopia. Sci Rep. 2024;14(1):508.
Naidoo K, Yende-Zuma N, Augustine S. A retrospective cohort study of body mass index and survival in HIV-infected patients with and without TB co-infection. Infect Dis Poverty. 2018;7:1-6.
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