title: Predictors of change in nutritional and hemoglobin status among adults treated for tuberculosis in Tanzania.
abstract: BACKGROUND
  Patients with tuberculosis (TB) often suffer from profound malnutrition.
  
  
  OBJECTIVE
  To examine the patterns and predictors of change in nutritional and hemoglobin status during and after TB treatment.
  
  
  METHODS
  A total of 471 human immunodeficiency virus (HIV) positive and 416 HIV-negative adults with pulmonary TB were prospectively followed in Dar es Salaam, Tanzania. All patients received 8 months' TB treatment following enrollment.
  
  
  RESULTS
  About 40% of HIV-positive and 47% of HIV-negative TB patients had body mass index (BMI) < 18.5 kg/m 2 at baseline, while about 94% of HIV-positive and 84% of HIV-negative participants were anemic at baseline. Both HIV-positive and HIV-negative patients experienced increases in BMI and hemoglobin concentrations over the course of TB treatment. Among HIV- positive patients, older age, low CD4 cell counts, and high viral load were independently associated with a smaller increase in BMI from baseline to 8 months. Fe- male sex, older age, low CD4 cell counts, previous TB infection and less money spent on food were independently associated with a smaller improvement in hemoglobin levels among HIV-positive patients during treatment.
  
  
  CONCLUSIONS
  HIV-positive TB patients, especially those with low CD4 cell counts, showed poor nutritional recovery during TB treatment. Adequate nutritional support should be considered during TB treatment.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts 02115, USA. kkawai8@gmail.com
authors.forename: K
authors.initials: K
authors.lastname: Kawai
authors.forename: E
authors.initials: E
authors.lastname: Villamor
authors.forename: F M
authors.initials: FM
authors.lastname: Mugusi
authors.forename: E
authors.initials: E
authors.lastname: Saathoff
authors.forename: W
authors.initials: W
authors.lastname: Urassa
authors.forename: R J
authors.initials: RJ
authors.lastname: Bosch
authors.forename: D
authors.initials: D
authors.lastname: Spiegelman
authors.forename: W W
authors.initials: WW
authors.lastname: Fawzi
mesh_terms: D000328:Adult; D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D000995:Antitubercular Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D060085:Coinfection; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006305:Health Status Indicators; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D016014:Linear Models; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015999:Multivariate Analysis; D009752:Nutritional Status; D018529:Nutritional Support; D011446:Prospective Studies; D013636:Tanzania / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D015415:Biomarkers; D006454:Hemoglobins