Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
World Health Organization, Nairobi, Kenya.
Int J Tuberc Lung Dis. 2018 Jun 1;22(6):649-654. doi: 10.5588/ijtld.17.0537.
Undernourishment is prevalent among tuberculosis (TB) patients. Nutritional support is given to TB patients to prevent and treat undernourishment; it is also used to improve treatment outcomes and as an incentive to keep patients on treatment.
To determine whether nutritional support is associated with a reduction in the risk of loss to follow-up (LTFU) among TB patients in Kenya.
This was a retrospective cohort study using national programmatic data. Records of 362 685 drug-susceptible TB patients from 2012 to 2015 were obtained from Treatment Information from Basic Unit (TIBU), a national case-based electronic data recording system. Patients who were LTFU were compared with those who completed treatment.
Nutrition counselling was associated with an 8% reduction in the risk of LTFU (RR 0.92, 95%CI 0.89-0.95), vitamins were associated with a 7% reduction (adjusted RR [aRR] 0.93, 95%CI 0.90-0.96) and food support was associated with a 10% reduction (aRR 0.90, 95%CI 0.87-0.94). Among patients who received food support, the addition of nutrition counselling was associated with a 23% reduction in the risk of LTFU (aRR 0.77, 95%CI 0.67-0.88).
Nutritional support was associated with a reduction in the risk of LTFU. Providing nutrition counselling is important for patients receiving food support.
营养不良在结核病（TB）患者中很普遍。为预防和治疗营养不良，为 TB 患者提供营养支持；它也用于改善治疗结果，并作为激励患者继续治疗的手段。
确定在肯尼亚，营养支持是否与降低结核病患者失访（LTFU）风险相关。
这是一项使用国家规划数据的回顾性队列研究。从国家基于病例的电子数据记录系统治疗信息基础单位（TIBU）获得了 2012 年至 2015 年 362685 例药物敏感结核病患者的记录。将失访患者与完成治疗的患者进行比较。
营养咨询与 LTFU 风险降低 8%相关（RR 0.92，95%CI 0.89-0.95），维生素与 LTFU 风险降低 7%相关（调整后的 RR [aRR] 0.93，95%CI 0.90-0.96），而食物支持与 LTFU 风险降低 10%相关（aRR 0.90，95%CI 0.87-0.94）。在接受食物支持的患者中，添加营养咨询与 LTFU 风险降低 23%相关（aRR 0.77，95%CI 0.67-0.88）。
营养支持与降低 LTFU 风险相关。为接受食物支持的患者提供营养咨询很重要。
