Bodyweight gain to predict treatment outcome in patients with pulmonary tuberculosis in 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.
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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