title: Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death.
abstract: A study was conducted in new patients registered with tuberculosis (TB) in a rural district of Malawi to determine (i) the prevalence of malnutrition on admission and (ii) the association between malnutrition and early mortality (defined as death within the first 4 weeks of treatment). There were 1181 patients with TB (576 men and 605 women), whose overall rate of infection with human immunodeficiency virus (HIV) was 80%. 673 TB patients (57%) were malnourished on admission (body mass index [BMI] < 18.5 kg/m2). There were 259 patients (22%) with mild malnutrition (BMI 17.0-18.4 kg/m2), 168 (14%) with moderate malnutrition (BMI 16.0-16.9 kg/m2) and 246 (21%) with severe malnutrition (BMI < 15.9 kg/m2). 95 patients (8%) died during the first 4 weeks. Significant risk factors for early mortality included increasing degrees of malnutrition, age > 35 years, and HIV seropositivity. Among all the 1181 patients, 10.9% of the 414 patients with moderate to severe malnutrition died in the first 4 weeks compared with 6.5% of the 767 patients with normal to mild malnutrition (odds ratio 1.8, 95% confidence interval 1.1-2.7). In patients with TB, BMI < 17.0 kg/m2 is associated with an increased risk of early death.
authors.affiliation: Médecins Sans Frontières-Luxembourg, Thyolo District, Malawi. zachariah@internet.lu
authors.forename: R
authors.initials: R
authors.lastname: Zachariah
authors.forename: M P
authors.initials: MP
authors.lastname: Spielmann
authors.forename: A D
authors.initials: AD
authors.lastname: Harries
authors.forename: F M L
authors.initials: FM
authors.lastname: Salaniponi
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000150:complications / Q000401:mortality; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006801:Humans; D016015:Logistic Models; D008295:Malawi / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009748:Nutrition Disorders / Q000150:complications / Q000401:mortality*; D009752:Nutritional Status; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health; D014376:Tuberculosis / Q000150:complications / Q000401:mortality*