Association between nutritional status and tuberculosis treatment outcomes among children on tuberculosis treatment in the south-west Shoa, Oromia, Ethiopia 2022: Cohort Study

Abstract

Abstract Background Childhood Tuberculosis and malnutrition are prevalent and have consequences, particularly in low-income countries like Ethiopia and children are especially vulnerable. Studies have been conducted to understand as nutritional status of children is associated with treatment outcomes, which continuously cause disease severity and risk of mortality in the world including in Ethiopia. Methods A retrospective cohort study was conducted, from January 2017 to December 2021, among 258 children with TB treated in 16 health facilities, 172 well-nourished and 86 malnourished. Patient charts were selected using a systematic random sampling method. The data were entered by Epi-data version 4.2 while analysis was carried out using SPSS version 25. We compared TB treatment outcomes in children with malnourished versus children well-nourished at diagnosis. An odds ratio with a 95% confidence interval was computed to determine the level of significant association. On multivariable analysis, those variables having a p-value of < 0.05 were considered statically significant predictors of the for-treatment outcomes of patients. Results The charts of 258 patients were reviewed which makes a 100% response rate. A total of 86 malnourished (<-2-Z score) patients and 172 normal or well-nourished patients (>=-2-Z score) were included in the final analysis of the study. The proportion of successful treatment outcomes among Children with malnourished and well-nourished was 93% and 99.4%, respectively. Age < 1 (AOR = 0.04, 95%CI: 0.002, 0.6), malnourished (AOR: 6.3, 95%CI: 1.8, 22.4), smear PTB+ (AOR: 0.5, 95%CI: 0.2, 0.9), HIV positive (AOR: 0.18, 95%CI: 0.1, 0.8), food support (AOR: 5, 95%CI: 1.5, 17), were factors significantly predictors of treatment outcomes. Conclusion This study suggests a low success rate in children malnourished. Age < 1, nutrition (severe acute malnourished), co-morbidity with the HIV smear PTB+, and male were predictors of lower successful treatment outcomes.