CLINICAL AND PATHOGENETIC SIGNIFICANCE OF NUTRITIONAL DEFICIENCY IN TUBERCULOSIS
Keywords:
tuberculosis, nutritional deficiency, body mass index, albumin, malnutritionAbstract
Eighty-two patients aged 18–65 years with newly diagnosed drug-sensitive active pulmonary tuberculosis who were receiving inpatient treatment were included in the study. A comprehensive assessment of nutritional status and its dynamics was performed during standard anti-tuberculosis therapy. It was established that in a significant proportion of patients tuberculosis was accompanied by pronounced nutritional deficiency, manifested by a reduced body mass index and hypoalbuminemia. During treatment, a statistically significant improvement in nutritional parameters was observed, while early weight gain and an increase in serum albumin levels demonstrated clear prognostic significance. In the prevention of adverse tuberculosis outcomes, an important role should be assigned to systematic screening of nutritional status, monitoring of body weight dynamics, and the incorporation of targeted nutritional support into standard patient management protocols.
References
Agarwal A.K. et al. Hypoalbuminemia and outcomes in pulmonary tuberculosis // J Family Med Prim Care. – 2023. – Vol. 12(4). – P. 752–758.
Bhargava A. et al. Nutritional assessment and intervention in tuberculosis care // Natl Med J India. – 2013. – Vol. 26(6). – P. 331–335.
Cegielski J.P., McMurray D.N. The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals // Int J Tuberc Lung Dis. – 2004. – Vol. 8(3). – P. 286–298.
Gupta K.B., Gupta R., Atreja A. Tuberculosis and nutrition // Lung India. – 2009. – Vol. 26(1). – P. 9–16.
Heidarnezhad F. et al. Nutritional status in active and latent tuberculosis infection // Iran J Public Health. – 2016. – Vol. 45(11). – P. 1441–1448.
Karyadi E. et al. Micronutrients and immune response in tuberculosis // Clin Infect Dis. – 2002. – Vol. 35(8). – P. 935–942.
Musuenge B.B. et al. Nutritional status of tuberculosis patients in Burkina Faso // BMC Public Health. – 2020. – Vol. 20. – Article 1831.
Onwubalili J.K. Malnutrition among tuberculosis patients in developing countries // J R Soc Health. – 1988. – Vol. 108(4). – P. 130–133.
Phan M.N. et al. Early weight gain and treatment outcomes in tuberculosis // Int J Tuberc Lung Dis. – 2016. – Vol. 20(5). – P. 635–641.
Phan MN, Guy ES, Nickson RN, Kao CC. Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America. Int J Infect Dis. 2016 Dec;53:1– 5.
Scrimshaw N.S., SanGiovanni J.P. Synergism of nutrition, infection, and immunity // Am J Clin Nutr. – 1997. – Vol. 66(2). – P. 464S–477S.
Semba R.D. et al. Undernutrition and tuberculosis risk: systematic review // PLoS Med. – 2016. – Vol. 13(11). – e1002167.
Sultan K.M. Nutritional status of pulmonary tuberculosis patients in Baghdad // J Fac Med Baghdad. – 2012. – Vol. 54(1). – P. 30–34.
Van Lettow M. et al. / IGIMS Patna cohort, Int J Tuberc Lung Dis, 2004 / India
Van Lettow M. et al. Weight gain during tuberculosis treatment and its association with survival // Int J Tuberc Lung Dis. – 2004. – Vol. 8(9). – P. 1055–1061.
Vasantha M, Gopi PG, Subramani R. Weight gain in patients with tuberculosis treated under directly observed treatment short-course (DOTS). Indian J Tuberc. 2009 Jan;56(1):5-9. PMID: 19402266.
WHO. Guideline: nutritional care and support for patients with tuberculosis. – Geneva: WHO, 2013.
World Health Organization. Global tuberculosis report 2023. – Geneva: WHO, 2023.
