Factors associated with malnutrition among newly diagnosed adult tuberculosis patients; case study: Kamwenge district

Abstract

Background: Malnutrition is a major contributor to increased morbidity and mortality, decreased function and quality of life, increased frequency and length of hospital stay, and higher health care costs. The burden of malnutrition is higher among TB patients. It is a strong risk factor for progression from latent tuberculosis to active form of the disease, just as TB can lead to or worsen pre-existing malnutrition by decreasing appetite, and by increased catabolism. Objective:This study was set out to ascertain the burden and explore the factors associated with malnutrition in the newly diagnosed TB patients in Kamwenge District. The study determined the incidence and factors associated with, and experiences regarding malnutrition among newly diagnosed TB patients in Kamwenge District. Methodology: The study was cross sectional in nature. It applied both quantitative and qualitative methods. Data collection was done by researcher-administered interviews, and was conducted at ten public health facilities and two private-not-for-profit health facilities in Kamwenge District. One hundred fifty eight newly diagnosed TB patients participated in the study. Sampling was done purposively at the participating health facilities, and data was analysed through descriptive, analytical and phenomenological techniques. Results: Almost all, 144(91.1%) of the study participants were malnourished. On logistic linear regression and multivariate analysis, the only factors that significantly influenced malnutrition among newly diagnosed TB patients were: challenges accessing food for home consumption and positive HIV serostatus.Patients reported negative experiences related to physiological challenges, social challenges, and effects of treatment. However, some of them reported positive experiences such as good handling by health workers, access to treatment, and improved health. Conclusion and Implication for Public Health Practice: Newly diagnosed TB patients have a high rate of malnutrition (>91%) and this is strongly related to challenges in accessing food and positive HIV sero status. Further, malnutrition in TB diseases is associated with negative experiences related to physiological and social challenges caused by the disease, and the negative effects of treatment/drugs. These findings underscore the need for public health practitioners, policy makers and promoters to actively strive for improvements in prioritization and service delivery to ensure early diagnosis and treatment of malnutrition among persons newly diagnosed with tuberculosis. Recommendations: Ministry of health and district health departmentsshould ensure that health facilities are well stocked with all relevant medicines and other supplies for combating malnutrition among newly diagnosed TB patients, considering that majority of them are malnourished. They should also advocate for improved availability of food at household level as challenges in accessing food was implicated in malnutrition among newly diagnosed TB patients