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Free Content Bodyweight gain to predict treatment outcome in patients with pulmonary tuberculosis in Peru

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SETTING: Tuberculosis control programmes of two health care centres in the central rainforest of Peru.

OBJECTIVE: To evaluate if bodyweight gain (BWG) predicts treatment outcome in patients with pulmonary tuberculosis (PTB).

DESIGN: Retrospective cohort study of adults with PTB diagnosed between 1995 and 2004. BWG was assessed after month 1 of treatment, after the initial phase and at the end of treatment. Patients were stratified into two BWG categories, ≤5% and >5%. Failures and relapses were grouped together as unsuccessful treatment outcome.

RESULTS: A total of 650 patients were included: 7.2% (n = 47) had an unsuccessful outcome. Unsuccessful outcome was associated with BWG ≤ 5% at the end of treatment (RR 2.05, 95%CI 1.10–3.80), but not at the completion of month 1 (RR 0.99, 95%CI 0.52–1.88) or at completion of the initial phase (RR 1.46, 95%CI 0.82–2.57). Median BWG at completion of the initial phase was higher in cured patients (P = 0.007). BWG ≤ 5% at end of treatment (RR 2.35, 95%CI 1.17–4.72), initial sputum smear 2+ (RR 2.48, 95%CI 1.14–5.31) and positive smear microscopy at month 2 (RR 4.0, 95%CI 1.30–12.31) were independent predictors of unsuccessful treatment outcome.

CONCLUSION: BWG ≤ 5% at the end of treatment, high bacterial load and lack of sputum conversion correlate with unsuccessful treatment outcome in this setting. New discriminative cut-offs for BWG are proposed.
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Keywords: bodyweight gain; pulmonary tuberculosis; relapse; treatment failure

Document Type: Regular Paper

Affiliations: 1: Instituto de Medicina Tropical ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru 2: Universidad Peruana Cayetano Heredia, Lima, Peru 3: Instituto de Medicina Tropical ‘Alexander von Humboldt’, Universidad Peruana Cayetano Heredia, Lima, Peru; and Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas, Hospital Nacional Cayetano Heredia, Lima, Peru

Publication date: October 1, 2008

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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