Association of Nutritional Status with Drug Sensitive and Drug Resistant Outcomes Among Pulmonary Tuberculosis Patients

Abstract

The study established the association of nutritional status with drug sensitive and drug resistant outcomes among pulmonary tuberculosis (TB) patients. A hospital based prospective follow-up cohort study design. Two urban Directly Observed Treatment Short-course (DOTS) centers in Lucknow District of Uttar Pradesh, India. The newly diagnosed Acid-fast Bacilli (AFB) positive cases between the age group of 12 to 65 years were enrolled. The drug-susceptibility outcomes were assessed by mycobacterial culture and drug-susceptibility test. The assessment of nutritional status was performed by Body Mass Index (BMI), Mid-upper-arm circumference (MUAC), 24-hour dietary recall method and measurement of serum concentration of retinol-binding protein (RBP) and zinc. A total of 185 newly diagnosed patients were recruited. Out of these, 14 patients were lost to follow up after treatment. The mean (±SD) age of the remaining 171 patients was 29 (±12) years. In the culture of 171 patients, 156 (91.2%) isolates were culture positive and subjected to drug-susceptibility test. Of these, 129 (82.6%) isolates were sensitive to all the drugs and 27 (17.3%) isolates were resistant to any drug. A significant difference was observed in serum RBP (p<0.0001) and zinc (p=0.005) at six month in drug sensitive and resistant patients. Among all the nutritional status parameters serum zinc (p=0.01) was significantly associated with drug resistant patients. Inadequate level of serum zinc was probably associated with drug resistance among new pulmonary TB patients.