O Mansour1, E O Masini2, B-S J Kim3, M Kamene4, M M Githiomi4, C L Hanson3. 1. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. 2. World Health Organization, Nairobi, Kenya. 3. Macalester College, St. Paul, Minnesota, USA. 4. National Tuberculosis, Leprosy and Lung Disease Program, Ministry of Health, Nairobi, Kenya.
Abstract
SETTING: Undernourishment is prevalent among tuberculosis (TB) patients. Nutritional support is given to TB patients to prevent and treat undernourishment; it is also used to improve treatment outcomes and as an incentive to keep patients on treatment. OBJECTIVE: To determine whether nutritional support is associated with a reduction in the risk of loss to follow-up (LTFU) among TB patients in Kenya. DESIGN: This was a retrospective cohort study using national programmatic data. Records of 362 685 drug-susceptible TB patients from 2012 to 2015 were obtained from Treatment Information from Basic Unit (TIBU), a national case-based electronic data recording system. Patients who were LTFU were compared with those who completed treatment. RESULTS: Nutrition counselling was associated with an 8% reduction in the risk of LTFU (RR 0.92, 95%CI 0.89-0.95), vitamins were associated with a 7% reduction (adjusted RR [aRR] 0.93, 95%CI 0.90-0.96) and food support was associated with a 10% reduction (aRR 0.90, 95%CI 0.87-0.94). Among patients who received food support, the addition of nutrition counselling was associated with a 23% reduction in the risk of LTFU (aRR 0.77, 95%CI 0.67-0.88). CONCLUSION: Nutritional support was associated with a reduction in the risk of LTFU. Providing nutrition counselling is important for patients receiving food support.
SETTING: Undernourishment is prevalent among tuberculosis (TB) patients. Nutritional support is given to TB patients to prevent and treat undernourishment; it is also used to improve treatment outcomes and as an incentive to keep patients on treatment. OBJECTIVE: To determine whether nutritional support is associated with a reduction in the risk of loss to follow-up (LTFU) among TB patients in Kenya. DESIGN: This was a retrospective cohort study using national programmatic data. Records of 362 685 drug-susceptible TB patients from 2012 to 2015 were obtained from Treatment Information from Basic Unit (TIBU), a national case-based electronic data recording system. Patients who were LTFU were compared with those who completed treatment. RESULTS: Nutrition counselling was associated with an 8% reduction in the risk of LTFU (RR 0.92, 95%CI 0.89-0.95), vitamins were associated with a 7% reduction (adjusted RR [aRR] 0.93, 95%CI 0.90-0.96) and food support was associated with a 10% reduction (aRR 0.90, 95%CI 0.87-0.94). Among patients who received food support, the addition of nutrition counselling was associated with a 23% reduction in the risk of LTFU (aRR 0.77, 95%CI 0.67-0.88). CONCLUSION: Nutritional support was associated with a reduction in the risk of LTFU. Providing nutrition counselling is important for patients receiving food support.
Authors: A Kairu; S Orangi; R Oyando; E Kabia; P Nguhiu; J Ong Ang O; N Mwirigi; Y V Laurence; N Kitson; I Garcia Baena; A Vassall; E Barasa; S Sweeney; L Cunnama Journal: Int J Tuberc Lung Dis Date: 2021-12-01 Impact factor: 2.373
Authors: Jennifer Furin; Marian Loveday; Sindisiwe Hlangu; Lindy Dickson-Hall; Sacha le Roux; Mark Nicol; Helen Cox Journal: BMC Public Health Date: 2020-01-17 Impact factor: 4.135