Shah Viral, Murugan Yogesh, Patel Shubham S, Trivedi Nidhi S, Pithadiya Dhiren, Makwana Naresh, Parmar Dipesh
Community and Family Medicine, Shri Meghji Pethraj (MP) Shah Government Medical College, Jamnagar, IND.
Community and Family Medicine, Shri Meghji Pethraj (MP) Shah Government Medical College, Guru Gobind Singh Government Hospital, Jamnagar, IND.
Cureus. 2024 Sep 27;16(9):e70300. doi: 10.7759/cureus.70300. eCollection 2024 Sep.
Tuberculosis (TB) remains a significant global health challenge, with malnutrition being a key risk factor for poor outcomes. This study aimed to evaluate the impact of nutritional supplementation on treatment outcomes in drug-sensitive pulmonary tuberculosis (DS-PTB) patients and explore patient perspectives on nutrition during TB treatment.
We conducted a mixed methods study in the Jamnagar district of Gujarat, India. The quantitative component was a retrospective cohort study comparing 645 DS-PTB patients who received nutritional supplements with 645 patients who did not. The primary outcomes were cure rates, mortality, and weight gain. Qualitative data were collected through in-depth interviews of 240 patients to explore their experiences and perceptions regarding nutrition during TB treatment.
Patients receiving nutritional supplements had significantly higher cure rates (482/645, n=74.7% vs 328/645, n=50.9%, OR: 2.86, 95% CI: 2.26-3.61, p<0.001) and lower mortality (7/645, n=1.1% vs 37/645, n=5.7%, OR: 0.18, 95% CI: 0.08-0.41, p<0.001) compared to the non-supplemented group. The group that received nutritional supplementation showed greater weight gain over six months (6.5 kg vs 3.1 kg, p<0.001). Qualitative findings revealed that patients who received nutritional supplementation reported improved appetite, increased energy, and faster symptom resolution while control group participants faced financial constraints and reduced appetite as barriers to adequate nutrition.
Nutritional supplementation significantly improved treatment outcomes in DS-PTB patients, including higher cure rates, reduced mortality, and enhanced weight gain. Patient perspectives highlighted the multifaceted impact of nutritional support. These findings suggest that integrating nutritional supplementation into standard TB care could substantially improve patient outcomes and experiences.
结核病仍然是一项重大的全球健康挑战，营养不良是导致不良后果的关键风险因素。本研究旨在评估营养补充对药物敏感型肺结核（DS-PTB）患者治疗结局的影响，并探讨患者在结核病治疗期间对营养的看法。
我们在印度古吉拉特邦的贾姆讷格尔地区进行了一项混合方法研究。定量部分是一项回顾性队列研究，比较了645名接受营养补充的DS-PTB患者和645名未接受营养补充的患者。主要结局指标为治愈率、死亡率和体重增加情况。通过对240名患者进行深入访谈收集定性数据，以探讨他们在结核病治疗期间对营养的体验和看法。
与未接受营养补充的组相比，接受营养补充的患者治愈率显著更高（482/645，n = 74.7% 对比 328/645，n = 50.9%，OR：2.86，95% CI：2.26 - 3.61，p < 0.001）且死亡率更低（7/645，n = 1.1% 对比 37/645，n = 5.7%，OR：0.18，95% CI：0.08 - 0.41，p < 0.001）。接受营养补充的组在六个月内体重增加更多（6.5千克对比3.1千克，p < 0.001）。定性研究结果显示，接受营养补充的患者报告食欲改善、精力增加且症状缓解更快，而对照组参与者面临经济限制和食欲下降，这些是获得充足营养的障碍。
营养补充显著改善了DS-PTB患者的治疗结局，包括更高的治愈率、更低的死亡率和更多的体重增加。患者的看法突出了营养支持的多方面影响。这些研究结果表明，将营养补充纳入标准结核病护理中可大幅改善患者的结局和体验。
