Bhargava Anurag, Bhargava Madhavi, Pande Tripti, Rao Raghuram, Parmar Malik
Department of Medicine, Yenepoya Medical College, Mangalore, Karnataka, India; Center for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore, Karnataka, India.
Department of Community Medicine, Yenepoya Medical College, Mangalore, Karnataka, India; Center for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore, Karnataka, India.
Indian J Tuberc. 2019 Jan;66(1):193-196. doi: 10.1016/j.ijtb.2018.10.005. Epub 2018 Nov 7.
Undernutrition is the most prevalent comorbidity in patients with tuberculosis (TB) in India. Undernutrition is often severe and results in higher risk of death, drug toxicity during treatment, poor functional status at end of treatment and a higher risk of relapse after successful treatment. A World Health Organization guideline has recommended nutritional assessment, counseling, and care as integral parts of TB care. The Revised National Tuberculosis Control Programme has recognized undernutrition as a significant comorbidity, released a guidance document for improving nutritional care and support, and launched a scheme for direct bank transfer of monthly cash benefit to TB patients. However, there are gaps at the provider level on nutritional assessment, due to challenges in calculation and interpretation of body mass index (BMI). A mobile based application has been developed for use in the programme, which makes estimation of BMI possible, classifies the severity of undernutrition, suggests triage and clinical actions based on the BMI, indicates desirable body weight corresponding to a BMI of 21 kg/m, and the daily caloric and protein intake for underweight patients with active TB. The app also provides tips for dietary counseling for TB patients, information on the major food groups, emphasizes an adequate and balanced diet from locally available foods for nutritional recovery of TB patients.
营养不良是印度结核病患者中最普遍的合并症。营养不良往往很严重，会导致更高的死亡风险、治疗期间的药物毒性、治疗结束时功能状态不佳以及成功治疗后更高的复发风险。世界卫生组织的一项指南建议将营养评估、咨询和护理作为结核病护理的组成部分。修订后的国家结核病控制规划已将营养不良视为一种重要的合并症，发布了一份改善营养护理和支持的指导文件，并启动了一项每月直接向结核病患者银行转账现金福利的计划。然而，由于体重指数（BMI）计算和解释方面的挑战，在提供者层面的营养评估存在差距。已开发出一种基于移动设备的应用程序供该计划使用，它可以进行BMI估算，对营养不良的严重程度进行分类，根据BMI建议分诊和临床行动，指出对应于21kg/m²BMI的理想体重，以及活动性结核病体重过轻患者的每日热量和蛋白质摄入量。该应用程序还提供针对结核病患者饮食咨询的提示、主要食物组的信息，强调从当地可得食物中获取充足且均衡的饮食以促进结核病患者的营养恢复。
