Nutritional Status and Other Associated Factors of Patients with Tuberculosis in Selected Urban Areas of Bangladesh

Abstract

Adequate nutrition is necessary for normal health and proper functioning of all body systems. Malnutrition has a substantial effect on cellular immunity. Because cell-mediated immunity (CMI) is the major host defense against tuberculosis (TB), malnutrition is an important risk factor. The purpose of this study was to assess the prevalence and factors associated with undernutrition among adult patients with TB in different urban areas of Bangladesh. A cross-sectional study was conducted in 12 different directly observed treatment short-course (DOTS) centers of Dhaka, Gazipur and Narayanganj City Corporation in Bangladesh among 314 adult patients with tuberculosis (TB) from January to June 2023. Data were collected through face‒to-face interviews with a semi structured questionnaire, and anthropometric measurements (height, weight) were measured with a bathroom scale and measuring tape. The nutritional status was categorized into three categories: (i) underweight (BMI <18.5 kg/m2), (ii) normal weight (BMI 18.5–24.9 kg/m2) and (iii) overweight (BMI>24.9 kg/m2). Chi-square tests and multiple logistic regression analyses were performed to determine the correlates of nutritional status. Underweight patients accounted for 33.4% of all 314 TB patients, whereas individuals with a normal BMI and overweight and obese individuals accounted for 45.5% and 21%, respectively. The mean age of the respondents was 35.18±14.97 years, and 51.3% were male. More than half of the respondents (55.1%) had extrapulmonary TB, and 91.4% were receiving anti-TB treatment for less than six months. Approximately 10.8% of the patients had diabetes mellitus, which is significantly associated with the nutritional status of TB patients (p<0.05). TB treatment duration (OR = 3.639, 95% CI: 1.193–11.085, p = 0.023) and age group (OR = 2.94, 95% CI: 0.994–6.253, p = 0.051) were associated with an increased odds ratio of underweight. According to the current study, approximately one-third of TB patients in urban areas of Bangladesh are underweight; therefore, nutritional status should be considered part of adult TB treatment.