Under-nutrition among adult tuberculosis patients completing intensive-phase treatment at public health facilities in Kembata Zone, Central Ethiopia Region
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(Published version)
Date
2025
Authors
Deffase, R.A.
Miller, E.R.
Fuge, T.G.
Gizachew, A.
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BMC Infectious Diseases, 2025; 25(1):1305-1-1305-8
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Rediet A. Deffase, Emma R. Miller, Terefe G. Fuge, and Addisalem Gizachew
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Abstract
Background: Nutritional impacts of tuberculosis (TB) have long been recognised. According to the national TB treatment guidelines, individuals with TB are assessed for under-nutrition during treatment initiation and receive regular nutritional counselling and support, including food supplementation, when the condition is detected. However, the extent of under-nutrition after completing intensive-phase of treatment, which may indicate its potential persistence, remains unclear especially in resource-limited settings. Objective: This study aimed to assess the extent of under-nutrition and associated factors among adult TB patients completing intensive-phase treatment at public health facilities of Kembata Zone, Central Ethiopia Region. Methods: We conducted a cross sectional facility-based study among 334 adult TB patients in the continuous-phase treatment. Participants were recruited using a cluster sampling technique. Bivariate logistic regression analysis was performed to assess the association between under-nutrition and explanatory variables. Odds ratios along with 95% confidence interval (CI) were estimated to identify factors significantly associated with under-nutrition using multivariable logistic regression analysis. The level of statistical significance was determined at P-value less than 0.05. Results: Under-nutrition was detected in almost 19% of participants. Sociodemographic and clinical factors contributed to the presence of under-nutrition in the continuous-phase of treatment. Not attending formal education (AOR: 4.2; 95%CI: 1.7–10.4) and living in a family of more than five (AOR: 2.3; 95%CI: 1.2–4.6) were sociodemogrphic factors associated with the occurrence of under-nutrition. Having extra-pulmonary TB (EPTB) (AOR: 3.2; 95%CI: 1.4–7.6) and shorter length (less than four months) of treatment (AOR: 4.3; 95%CI: 1.9–9.5) were clinical conditions linked with under-nutrition. Conclusions: Our study identified a higher prevalence of under-nutrition in the continuous-phase of TB treatment than the targets of clinical guidelines, which expect optimal nutritional status in all patients. This may suggest potential persistence of poor nutritional status (or a lack of weight gain) from the earlier period of treatment. This may reflect lower understandings of the nutritional impact of TB in association with a lack of formal education, and a limited adequate diet due to a larger family size. Being in the earlier period of continuous-phase treatment and having EPTB also increased the likelihood of under-nutrition. Continuous monitoring and support is suggested throughout the treatment course with a particular focus on individuals with a lower socioeconomic background and EPTB.
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© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.