Nutritional status in Malawian patients with pulmonary tuberculosis and response to chemotherapy

Anthropometric measurements, hand-grip dynamometry and serum albumin determinations were performed on 122 (73 m, 49 f) Malawian patients, aged 16-68 years, who were consecutively admitted to the chest wards, Kamuzu Central Hospital, Lilongwe, with sputum-positive pulmonary tuberculosis. Nutritional findings were compared with those obtained in healthy age- and sex-matched controls, and were also related to clinical and radiographic features. All patients received chemotherapy under supervision in hospital for 8 weeks, and nutritional status was monitored at 4-week intervals. Weight, muscle mass and function, subcutaneous fat and serum albumin were all significantly reduced compared with controls (P less than 0.001), and the nutritional deficit increased with the extent of radiographic disease. With chemotherapy there was a significant improvement at 4 weeks, and again at 8 weeks, in all nutritional indices (P less than 0.05), and this occurred irrespective of clinical, radiographic and nutritional features which were observed on admission. The results indicate that pulmonary tuberculosis is associated with a high degree of undernutrition, but this improves with effective chemotherapy.