Malnutrition and the severity of lung disease in adults with pulmonary tuberculosis in Malawi.
METHODS
Zomba Central Hospital, Zomba, Malawi.


OBJECTIVE
To examine the relationship between malnutrition and the severity of lung disease in human immunodeficiency virus (HIV) positive and negative adults with pulmonary tuberculosis (PTB).


METHODS
Cross-sectional study.


METHODS
Chest radiographs and anthropometric measurements were obtained and bioelectrical impedance analysis was conducted in sputum-positive patients with pulmonary tuberculosis. Lung disease in chest radiographs was graded as normal, minimal, moderately advanced and far advanced according to a conventional classification system.


RESULTS
Among 319 adults with PTB with or without HIV co-infection, body mass index (BMI), fat mass and phase angle were independently associated with increasing severity of lung disease. Multiple logistic regression analyses showed that BMI, fat mass and phase angle were associated with increasing severity of lung disease among 236 HIV-positive adults, when adjusted for sex, age, and plasma HIV load.


CONCLUSIONS
The severity of lung disease in adults with PTB is associated with the extent of malnutrition, as reflected by BMI and body composition studies using bioelectrical impedance analysis.
Van Lettow
M
M
Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Kumwenda
J J
JJ
Harries
A D
AD
Whalen
C C
CC
Taha
T E
TE
Kumwenda
N
N
Kang'ombe
C
C
Semba
R D
RD
D000328:Adult; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008295:Malawi; D008297:Male; D044342:Malnutrition / Q000150:complications*; D008875:Middle Aged; D011859:Radiography; D012720:Severity of Illness Index; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging