Adrina Vanyadhita1, Dian Kusumadewi2
1Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
2Department of Community Medicine, University of Indonesia, Jakarta, Indonesia
Abstract
Introduction: Tuberculosis infection remains a global problem especially in developing countries. In 2013, approximately 9 million of people were diagnosed with tuberculosis and 1.5 million died from tuberculosis. The association between tuberculosis and malnutrition is well established that tuberculosis can cause malnutrition and an individual with malnutrition is susceptible to tuberculosis.
Therefore, low body mass index (BMI) as seen in patients with tuberculosis is often present at the time of diagnosis.
Aim: to assess the role of body mass index in predicting the negative sputum conversion in patients with tuberculosis
Methods: Searching was carried out using the database of Pubmed, Cochrane Central Register of Clinical Trials and Science Direct on 20th March 2015. The search strategy included following keywords and combinations “body mass index AND pulmonary tuberculosis AND sputum conversion”. Three articles was included in the critical appraisal.
Results: A study conducted by Putri FA et al revealed severely low BMI (BMI < 16 kg/m2) is significantly associated with longer negative sputum conversion (HR 0.56, 95%CI 0.38–0.81 and lower probability of conversion before 4 months (aRR 0.67, 95%CI 0.56–0.93). A study by Kenangalem E et al showed that in patients with pulmonary tuberculosis, the time to predict the accomplishment in negative conversion of sputum culture by lower body mass index is not significant with p value of 0.91 and hazard ratio of
0.99 (95%CI 0.85-1.16). A study by Hesseling AC et al revealed low body mass index (BMI <18 kg/m2) is not significantly associated with sputum culture conversion after 2 months of treatment but it significantly predicted a tuberculosis recurrence within 24 months after the completion of treatment.
Conclusion:Based on the critical appraisal of three studies, the predictor factor of sputum conversion in patients with pulmonary tuberculosis by body mass index is not significant and needs further study.
Keywords: tuberculosis, body mass index, sputum conversion