Wondmieneh Adam, Gedefaw Getnet, Getie Addisu, Demis Asmamaw
Department of Nursing, College of Health Sciences, Woldia University, P.O.Box: 400, Woldia, Ethiopia.
Department of Midwifery, College of Health Sciences, Woldia University, P.O.Box: 400, Woldia, Ethiopia.
J Clin Tuberc Other Mycobact Dis. 2020 Dec 29;22:100211. doi: 10.1016/j.jctube.2020.100211. eCollection 2021 Feb.
Undernutrition and tuberculosis are the major public health problems of people living in middle and low-income countries. Even though single studies have been reported from different areas of Ethiopia, there is no national-level study that estimates the overall burden of undernutrition among tuberculosis patients. Therefore, this study aimed to estimate the overall magnitude of undernutrition among adult tuberculosis patients in Ethiopia.
We searched out records from databases such as PubMed/MEDLINE, HINARI, EMBASE, Scopus, Google Scholar, and African journals and the online Ethiopian University repositories for published and unpublished articles. The data were extracted using a standardized data extraction format. Meta-analysis was computed using STATA version 11 software. The Cochrane Q-test and I with its corresponding p-value were used to assess the heterogeneity of the study. The presence of publication bias was evaluated using Egger's test and presented with funnel plots. The random-effects -analysis model was computed to estimate the pooled prevalence of undernutrition among adult tuberculosis patients.
A total of Twelve observational studies with 4963 study participants were included in this systematic review and -analysis. The pooled prevalence of undernutrition among tuberculosis patients in Ethiopia was 50.8% (95% CI 43.97, 57.63). The results of subgroup analysis showed that the highest prevalence of undernutrition among TB patients was observed from studies done in the Amhara region (65.63%). In this -analysis, the pooled prevalence of undernutrition among TB-HIV co-infected patients was 45.45% (95%CI 21.85, 56.07).
The prevalence of undernutrition among TB patients in Ethiopia was noticeably high. The result of this study showed that undernutrition is more severe in the Amhara regional state. Additionally, TB-HIV co-infected patients are highly affected by undernutrition. Therefore, the Ministry of Health in collaboration with clinicians should give special attention to provide nutritional care and support for TB patients as part of regular care. Moreover, special nutritional support should be designed for TB-HIV co-infected patients.
营养不良和结核病是中低收入国家居民面临的主要公共卫生问题。尽管埃塞俄比亚不同地区已有单项研究报告，但尚无一项国家级研究对结核病患者中营养不良的总体负担进行评估。因此，本研究旨在估算埃塞俄比亚成年结核病患者中营养不良的总体严重程度。
我们在PubMed/MEDLINE、HINARI、EMBASE、Scopus、谷歌学术以及非洲期刊和埃塞俄比亚大学在线知识库等数据库中检索已发表和未发表的文章记录。使用标准化数据提取格式提取数据。使用STATA 11版软件进行荟萃分析。采用Cochrane Q检验及其对应的p值评估研究的异质性。使用Egger检验评估发表偏倚的存在情况，并绘制漏斗图展示。采用随机效应分析模型估算成年结核病患者中营养不良的合并患病率。
本系统评价和分析共纳入12项观察性研究，涉及4963名研究参与者。埃塞俄比亚结核病患者中营养不良的合并患病率为50.8%（95%可信区间43.97，57.63）。亚组分析结果显示，阿姆哈拉地区开展的研究中结核病患者营养不良患病率最高（65.63%）。在此分析中，结核病合并艾滋病病毒感染患者中营养不良的合并患病率为45.45%（95%可信区间21.85，56.07）。
埃塞俄比亚结核病患者中营养不良的患病率显著偏高。本研究结果表明，阿姆哈拉州营养不良情况更为严重。此外，结核病合并艾滋病病毒感染患者受营养不良影响严重。因此，卫生部应与临床医生合作，作为常规护理的一部分，特别关注为结核病患者提供营养护理和支持。此外，应为结核病合并艾滋病病毒感染患者设计特殊的营养支持措施。
