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Effectiveness of nutritional support to improve treatment adherence in patients with tuberculosis: a systematic
Fasil Wagnew1,2, Darren Gray3, Tsheten Tsheten1
1National Centre for Epidemiology and Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia.
Context:
Nutritional interventions substantially improve tuberculosis (TB) treatment outcomes and prevent complications. However, there is limited evidence about the connections between having nutritional support and TB treatment adherence.
Objective:
The aim of this study was to determine the effectiveness of nutritional support in improving treatment adherence among patients with TB.
Data Sources:
Databases, including PubMed, Embase (Ovid), Web of Science, and Scopus, were comprehensively reviewed to identify relevant studies reporting the impacts of nutritional support on TB treatment adherence.
Data Extraction:
Two authors independently screened the title, abstracts, and full article texts to identify eligible studies and assess the risk of bias. Observational and interventional studies were included.
Data Analysis:
A narrative synthesis approach was used to summarize the findings qualitatively.
Results:
From the search, 3059 publications were identified; of these, 8 studies were included in this systematic review. Three types of nutritional interventions were identified: food baskets (eg, energy, micronutrient- or macronutrient-enriched food support), nutritional advice and guidance, and incentives for buying foods. Although 5 studies reported that nutritional support significantly improved treatment adherence in patients with TB, 3 studies showed that nutritional support had no effect on TB treatment adherence.
Conclusions:
Providing nutritional support may improve adherence to TB treatment. However, more well-powered, high-quality trials are warranted to demonstrate the effect of nutrition support on cost-effectively improving adherence to TB treatment.
Systematic Review Registration:
PROSPERO registration no. CRD42023392162.
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