F A Putri1, E Burhan2, A Nawas2, P Z Soepandi2, D K Sutoyo2, H Agustin2, F Isbaniah2, D W Dowdy3. 1. Programmatic Management of Drug-resistant Tuberculosis Unit, Persahabatan Hospital, Jakarta, Indonesia. 2. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia. 3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Abstract
SETTING: Programmatic management of drug-resistant tuberculosis at Persahabatan Hospital, Jakarta, Indonesia. OBJECTIVE: To evaluate the association between body mass index (BMI) and sputum culture conversion during treatment for multidrug-resistant tuberculosis (MDR-TB). DESIGN: We conducted a retrospective cohort study of 212 MDR-TB patients. MDR-TB was confirmed using culture in liquid medium and line-probe assay. Patients were treated with a standardised regimen unless they were resistant to any of the drugs tested. Study outcomes were time to culture conversion (primary) and probability of conversion within 4 months (secondary). Data were analysed using Kaplan-Meier curves, discrete time-survival analysis and Poisson regression. RESULTS: Compared to patients with normal weight (BMI ≥18.5 kg/m(2)), severely underweight patients (BMI <16 kg/m(2)) had longer time to initial conversion (adjusted hazard ratio [aHR] 0.55, 95%CI 0.37-0.84) and a lower probability of sputum culture conversion within 4 months (adjusted relative risk 0.67, 95%CI 0.54-0.83). Other predictors for longer sputum culture conversion were female sex (aHR 0.55, 95%CI 0.39-0.78), resistance to injectables (aHR 0.59, 95%CI 0.42-0.83) and high baseline smear grade (aHR 0.33, 95%CI 0.18-0.60). CONCLUSION: Severe underweight was associated with longer time to initial sputum culture conversion among MDR-TB patients.
SETTING: Programmatic management of drug-resistant tuberculosis at Persahabatan Hospital, Jakarta, Indonesia. OBJECTIVE: To evaluate the association between body mass index (BMI) and sputum culture conversion during treatment for multidrug-resistant tuberculosis (MDR-TB). DESIGN: We conducted a retrospective cohort study of 212 MDR-TB patients. MDR-TB was confirmed using culture in liquid medium and line-probe assay. Patients were treated with a standardised regimen unless they were resistant to any of the drugs tested. Study outcomes were time to culture conversion (primary) and probability of conversion within 4 months (secondary). Data were analysed using Kaplan-Meier curves, discrete time-survival analysis and Poisson regression. RESULTS: Compared to patients with normal weight (BMI ≥18.5 kg/m(2)), severely underweight patients (BMI <16 kg/m(2)) had longer time to initial conversion (adjusted hazard ratio [aHR] 0.55, 95%CI 0.37-0.84) and a lower probability of sputum culture conversion within 4 months (adjusted relative risk 0.67, 95%CI 0.54-0.83). Other predictors for longer sputum culture conversion were female sex (aHR 0.55, 95%CI 0.39-0.78), resistance to injectables (aHR 0.59, 95%CI 0.42-0.83) and high baseline smear grade (aHR 0.33, 95%CI 0.18-0.60). CONCLUSION: Severe underweight was associated with longer time to initial sputum culture conversion among MDR-TB patients.
Authors: M Seifert; K Ajbani; S B Georghiou; D Catanzaro; C Rodrigues; V Crudu; T C Victor; R S Garfein; A Catanzaro; T C Rodwell Journal: Int J Tuberc Lung Dis Date: 2016-05 Impact factor: 2.373
Authors: Dylan B Tierney; Molly F Franke; Mercedes C Becerra; Félix A Alcántara Virú; César A Bonilla; Epifanio Sánchez; Dalia Guerra; Maribel Muñoz; Karim Llaro; Eda Palacios; Lorena Mestanza; Rocío M Hurtado; Jennifer J Furin; Sonya Shin; Carole D Mitnick Journal: PLoS One Date: 2014-09-19 Impact factor: 3.240