Body mass index predictive of sputum culture conversion among MDR-TB patients in Indonesia (original) (raw)

SETTING:

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).

DESIGN:

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/m2), severely underweight patients (BMI <16 kg/m2) 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).

CONCLUSION:

Severe underweight was associated with longer time to initial sputum culture conversion among MDR-TB patients.

Keywords: hospital;programmatic management of drug-resistant tuberculosis;severe underweight

Document Type: Research Article

Affiliations: 1: Programmatic Management of Drug-resistant Tuberculosis Unit, Persahabatan Hospital, Jakarta, Indonesia 2: Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia 3: Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

Publication date: 2014-05-01

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