title: Dietary counseling adherence during tuberculosis treatment: A longitudinal study.
abstract: BACKGROUND
  The World Health Organization (WHO) recommends the use of dietary counseling to overcome malnutrition for patients with tuberculosis, with or without HIV, however the response to nutritional treatment depends on patient's adherence to nutritional counseling.
  
  
  OBJECTIVE
  Identify the degree of adherence to dietary counseling and predictors of adherence among patients undergoing tuberculosis treatment.
  
  
  METHODS
  Observational prospective follow-up study conducted in adults treating for tuberculosis with or without HIV. Self-reported adherence and 24-h diet recall were checked. Diet counseling according to WHO strategy was offered at each visit for all patients. The endpoint was the adherence to the recommended dietary allowance (RDA) and total calories consumed during tuberculosis treatment. Data were mainly analyzed with marginal models to estimate adjusted trajectories.
  
  
  RESULTS
  Sixty-eight patients were included in the study. The maximum probability of total calories consumption of at least one RDA was 80%. The adherence to dietary counseling was low regardless of HIV infection. The negative determinants of adherence were the presence of loss of appetite and nausea/vomiting. For patients with loss of appetite and nausea/vomiting, the probability of total calories consumption of at least one RDA is less than 20% at any time.
  
  
  CONCLUSIONS
  The loss of appetite and nausea/vomiting are highly prevalents and were the main causes of non-adherence to dietary counseling.
authors.affiliation: Nutrition Service, National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation, Av. Brasil 4365, Rio de Janeiro, RJ, 21040-900, Brazil. Electronic address: adriana.bacelo@ini.fiocruz.br.
authors.forename: Adriana Costa
authors.initials: AC
authors.lastname: Bacelo
authors.affiliation: Clinical Research Laboratory on Chagas Disease, National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation, Av. Brasil 4365, Rio de Janeiro, RJ, 21040-900, Brazil. Electronic address: pedro.brasil@ini.fiocruz.br.
authors.forename: Pedro Emmanuel Alvarenga Americano
authors.initials: PE
authors.lastname: do Brasil
authors.affiliation: Nutrition Institute, Rio de Janeiro State University, Rua São Francisco Xavier 524, 12º Floor, Rio de Janeiro, RJ, 20550-900, Brazil. Electronic address: claudiacople@gmail.com.
authors.forename: Cláudia Dos Santos
authors.initials: CD
authors.lastname: Cople-Rodrigues
authors.affiliation: Diagnostics Activities Coordination, Immunodiagnostic Section, National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation, Av. Brasil 4365, Rio de Janeiro, RJ, 21040-900, Brazil. Electronic address: ingebourg.georg@ini.fiocruz.br.
authors.forename: Georg
authors.initials: G
authors.lastname: Ingebourg
authors.affiliation: Department of Nutrition, Augusto Motta University Center, Av. Paris 72, Rio de Janeiro, RJ, 21041-020, Brazil. Electronic address: elianepaivanutricao@gmail.com.
authors.forename: Eliane
authors.initials: E
authors.lastname: Paiva
authors.affiliation: Josué de Castro Institute, Rio de Janeiro's Federal University, Av. Carlos Chagas Filho, 373, CCS Block J, 2º Floor, Rio de Janeiro, RJ, 21941-901, Brazil. Electronic address: aramalho.rj@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ramalho
authors.affiliation: Clinical Research Laboratory on Mycobacteria, National Institute of Infectious Diseases Evandro Chagas, Oswaldo Cruz Foundation, Av. Brasil 4365, Rio de Janeiro, RJ, 21040-900, Brazil. Electronic address: valeria.rolla@ini.fiocruz.br.
authors.forename: Valeria Cavalcanti
authors.initials: VC
authors.lastname: Rolla
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D000995:Antitubercular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001069:Appetite Regulation; D001938:Brazil / Q000453:epidemiology; D060085:Coinfection; D003376:Counseling; D002149:Energy Intake; D005260:Female; D005500:Follow-Up Studies; D015658:HIV Infections / Q000188:drug therapy / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D044342:Malnutrition / Q000175:diagnosis / Q000178:diet therapy* / Q000453:epidemiology / Q000503:physiopathology; D008875:Middle Aged; D009325:Nausea / Q000453:epidemiology; D015596:Nutrition Assessment; D009752:Nutritional Status; D018529:Nutritional Support / Q000379:methods*; D009753:Nutritive Value; D010349:Patient Compliance; D011446:Prospective Studies; D064167:Recommended Dietary Allowances; D013997:Time Factors; D016896:Treatment Outcome; D014376:Tuberculosis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D014839:Vomiting / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents; D000995:Antitubercular Agents
keywords: Adherence; Compliance; Dietary counseling; HIV; Nutrition; Tuberculosis