Publication:

Change in body weight and treatment outcome in sputum positive pulmonary tuberculosis patients treated under directly observed treatment short-course

Background Patients with tuberculosis often suffer from severe weight loss and is used as useful marker to predict TB treatment outcome. Hence a study was planned with an objective to determine the change of patient’s body weight over time throughout treatment and to determine whether there was any association with treatment outcome.

Methods This was a retrospective cohort study, planned to be conducted among all smear positive pulmonary tuberculosis patients registered in a Tuberculosis Unit of Pune corporation, during the period of January to December 2015. Body weights of patients were recorded from TB treatment cards at the time of diagnosis, after 2 months of intensive phase of treatment and at the end of treatment. Total 344 cases were enrolled. Chi-Square test and Fisher’s exact test and repeated measure ANOVA test was used for analysis.

Results A bad outcome was more likely among the category II cases as compared to category I, among non-adherent to treatment cases in continuation phase and higher sputum grading at the time of diagnosis i. e. in 3+ sputum smear grading. The weights of the patients at the time of diagnosis, at end of intensive phase and at end of treatment showed statistical significant difference (p<0.0001). The weight gain, more so at end of treatment was significantly associated with good outcome.

Conclusions Weight gain has prognostic significance in patients with tuberculosis and should be considered as a surrogate marker to monitor response to TB treatment especially in developing countries where extensive laboratory tests are not feasible.