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Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death

R Zachariah1, M P Spielmann, A D Harries

  • 1Médecins Sans Frontières-Luxembourg, Thyolo District, Malawi. zachariah@internet.lu

Transactions of the Royal Society of Tropical Medicine and Hygiene
|August 15, 2002
PubMed

Insights

Malnutrition significantly increases early mortality risk in tuberculosis patients in Malawi. Patients with moderate to severe malnutrition (BMI < 17.0 kg/m2) faced a higher chance of death within four weeks of treatment.

Area of Science:

  • Global Health
  • Infectious Diseases
  • Nutritional Science

Background:

  • Tuberculosis (TB) remains a major global health challenge, particularly in low-income countries.
  • Malnutrition is a common comorbidity in TB patients, potentially impacting treatment outcomes.
  • High rates of human immunodeficiency virus (HIV) infection coexist with TB, further complicating patient management.

Purpose of the Study:

  • To determine the prevalence of malnutrition among new TB patients in rural Malawi.
  • To investigate the association between malnutrition and early mortality (within 4 weeks of treatment) in this population.

Main Methods:

  • A cohort study was conducted involving 1181 new TB patients in Malawi.
  • Nutritional status was assessed using body mass index (BMI) on admission.
  • Data on patient demographics, HIV status, and mortality within the first 4 weeks of treatment were collected and analyzed.

Main Results:

  • 57% of TB patients were malnourished (BMI < 18.5 kg/m2) on admission.
  • Severe malnutrition (BMI < 15.9 kg/m2) was prevalent in 21% of patients.
  • Early mortality occurred in 8% of patients, with increasing malnutrition severity, age over 35, and HIV seropositivity identified as significant risk factors.

Conclusions:

  • Malnutrition is highly prevalent in TB patients in Malawi and is significantly associated with increased early mortality.
  • A BMI < 17.0 kg/m2 was linked to a greater risk of death within the first four weeks of TB treatment.
  • Addressing malnutrition is crucial for improving treatment outcomes and reducing mortality in TB patients, especially in high HIV prevalence settings.

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