Please use this identifier to cite or link to this item:
https://www.arca.fiocruz.br/handle/icict/35008
Type
ArticleCopyright
Open access
Collections
- INI - Artigos de Periódicos [3397]
Metadata
Show full item record
NUTRITIONAL SUPPLEMENTATION IS A NECESSARY COMPLEMENT TO DIETARY COUNSELING AMONG TUBERCULOSIS AND TUBERCULOSIS-HIV PATIENTS
Author
Affilliation
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Serviço de Nutrição. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Doença de Chagas. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Institute of Nutrition. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Coordenação de Atividades Diagnósticas. Seção de Imunodiagnóstico. Rio de Janeiro, RJ, Brasil.
Centro Universitário Augusto Motta. Department of Nutrition. Rio de Janeiro, RJ, Brazil.
Sergio Franco Laboratory. Duque de Caxias, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Micobacterioses. Rio de Janeiro, RJ, Brasil.
Universidade Federal do Rio de Janeiro. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Doença de Chagas. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Institute of Nutrition. Rio de Janeiro, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Coordenação de Atividades Diagnósticas. Seção de Imunodiagnóstico. Rio de Janeiro, RJ, Brasil.
Centro Universitário Augusto Motta. Department of Nutrition. Rio de Janeiro, RJ, Brazil.
Sergio Franco Laboratory. Duque de Caxias, RJ, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Pesquisa Clínica em Micobacterioses. Rio de Janeiro, RJ, Brasil.
Abstract
The Brazilian Ministry of Health and the World Health Organization recommend dietary counseling for patients with malnutrition during tuberculosis treatment. Patients under tuberculosis therapy (infected and not infected with HIV) were followed-up to evaluate the effectiveness of dietary counseling. Objective: describe the nutritional status of patients with tuberculosis. Methods: an observational follow-up study over a 180-day period of tuberculosis therapy in adults was conducted. Subjects were assessed for body composition (using BMI, TSF and MUAC parameters), serum biomarkers and offered dietary counseling. The data obtained at each visit
(D15, D30, D60, D90, D120, D150, and D180) were analyzed, showing trajectories over time and central tendencies each time. Results: at baseline, the mean age was 41.1 (±13.4) years; they were predominantly male, with income lower than a local minimum wage and at least six years of schooling. Patients showed predominantly pulmonary tuberculosis. At baseline, all patients suffered from malnutrition. The overall energy malnutrition prevalence was of 70.6%. Anemia at baseline was observed in both groups (63.2%), however, it was significantly more pronounced in the HIV+. At the end, energy malnutrition was reduced to 57.1% (42.9% of HIV and 71.4% of the HIV+). Micronutrients malnutrition was evident in 71.4% of the HIV- patients and 85.7% of HIV+ patients at the end of tuberculosis therapy. Using BMI (≤18.5 kg/m2 cutoff) as an index of malnutrition, it was detected in 23.9% of the HIV- and 27.3% of the HIV+ patients at baseline, with no evident improvement over time; using TSF (≤11.4mm as cutoff) or MUAC (≤28.5cm as cutoff), malnutrition was detected in 70.1% and 85.3% of all patients, respectively. Nevertheless, combining all biomarkers, at the end of follow-up, all patients suffered from malnutrition. Conclusion: Although with a limited number of patients, the evidence does not support that dietary counseling is effective to recover from malnutrition in our population.
Share