title: Body mass index predictive of sputum culture conversion among MDR-TB patients in Indonesia.
abstract: METHODS
  Programmatic management of drug-resistant tuberculosis at Persahabatan Hospital, Jakarta, Indonesia.
  
  
  OBJECTIVE
  To evaluate the association between body mass index (BMI) and sputum culture conversion during treatment for multidrug-resistant tuberculosis (MDR-TB).
  
  
  METHODS
  We conducted a retrospective cohort study of 212 MDR-TB patients. MDR-TB was confirmed using culture in liquid medium and line-probe assay. Patients were treated with a standardised regimen unless they were resistant to any of the drugs tested. Study outcomes were time to culture conversion (primary) and probability of conversion within 4 months (secondary). Data were analysed using Kaplan-Meier curves, discrete time-survival analysis and Poisson regression.
  
  
  RESULTS
  Compared to patients with normal weight (BMI ≥18.5 kg/m(2)), severely underweight patients (BMI <16 kg/m(2)) had longer time to initial conversion (adjusted hazard ratio [aHR] 0.55, 95%CI 0.37-0.84) and a lower probability of sputum culture conversion within 4 months (adjusted relative risk 0.67, 95%CI 0.54-0.83). Other predictors for longer sputum culture conversion were female sex (aHR 0.55, 95%CI 0.39-0.78), resistance to injectables (aHR 0.59, 95%CI 0.42-0.83) and high baseline smear grade (aHR 0.33, 95%CI 0.18-0.60).
  
  
  CONCLUSIONS
  Severe underweight was associated with longer time to initial sputum culture conversion among MDR-TB patients.
authors.affiliation: Programmatic Management of Drug-resistant Tuberculosis Unit, Persahabatan Hospital, Jakarta, Indonesia.
authors.forename: F A
authors.initials: FA
authors.lastname: Putri
authors.affiliation: Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: E
authors.initials: E
authors.lastname: Burhan
authors.affiliation: Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: A
authors.initials: A
authors.lastname: Nawas
authors.affiliation: Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: P Z
authors.initials: PZ
authors.lastname: Soepandi
authors.affiliation: Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: D K
authors.initials: DK
authors.lastname: Sutoyo
authors.affiliation: Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: H
authors.initials: H
authors.lastname: Agustin
authors.affiliation: Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia.
authors.forename: F
authors.initials: F
authors.lastname: Isbaniah
authors.affiliation: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Dowdy
mesh_terms: D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001431:Bacteriological Techniques; D015992:Body Mass Index; D005260:Female; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000187:drug effects* / Q000302:isolation & purification; D009752:Nutritional Status; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D013183:Sputum / Q000382:microbiology*; D013851:Thinness / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D018088:Tuberculosis, Multidrug-Resistant / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology
chemical_list: D000995:Antitubercular Agents