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Abstract：
UNASSIGNED: The causal relationship between undernutrition and response to anti-tuberculosis (TB) treatment and TB treatment outcomes among people with retreatment TB is understudied.
UNASSIGNED: To evaluate the effect of undernutrition on treatment success and sputum smear conversion among people with retreatment drug-susceptible TB in Kampala, Uganda.
UNASSIGNED: We conducted a quasi-experimental study utilizing propensity score weighting among people with retreatment drug-susceptible TB aged ≥ 15 years treated between 2012 and 2022 in Kampala. The primary exposure was undernutrition assessed using the mid-upper arm circumference at the time of TB diagnosis. The primary outcome was treatment success defined as cure or treatment completion at month 6. Sputum smear conversion was the secondary outcome and was measured as a change in sputum smear status from positive to negative at months 2, 5, and 6. We estimated the causal effect of undernutrition on the outcomes using a propensity-score weighted modified Poisson regression model with robust error variance.
UNASSIGNED: Of the 605 participants, 432 (71.4 %) were male, 215 (35.5 %) were aged 25-34 years, 427 (70.6 %) had bacteriologically confirmed pulmonary TB, 133 (22.0 %) were undernourished and 398 (65.8 %) achieved treatment success. Of participants with bacteriologically confirmed pulmonary TB, 232 (59.0 %), 327 (59.3 %), and 360 (97.6 %) achieved sputum smear conversion at months 2, 5, and 6, respectively. Undernutrition reduced treatment success (RR 0.42, 95 % CI 0.32-0.55) as well as sputum smear conversion at months 2 (RR 0.45, 95 % CI 0.42-0.49) and 5 (RR 0.46, 95 % CI 0.43-0.51) but not month 6 (RR 0.99, 95 % CI 0.97-1.02).
UNASSIGNED: Undernutrition negatively impacts treatment outcomes. Therefore, nutritional assessment should be an integral component of TB care, with nutritional counseling and support offered to those undernourished to optimize their TB treatment response and outcomes.
UNASSIGNED: To evaluate the effect of undernutrition on treatment success and sputum smear conversion among people with retreatment drug-susceptible TB in Kampala, Uganda.
UNASSIGNED: We conducted a quasi-experimental study utilizing propensity score weighting among people with retreatment drug-susceptible TB aged ≥ 15 years treated between 2012 and 2022 in Kampala. The primary exposure was undernutrition assessed using the mid-upper arm circumference at the time of TB diagnosis. The primary outcome was treatment success defined as cure or treatment completion at month 6. Sputum smear conversion was the secondary outcome and was measured as a change in sputum smear status from positive to negative at months 2, 5, and 6. We estimated the causal effect of undernutrition on the outcomes using a propensity-score weighted modified Poisson regression model with robust error variance.
UNASSIGNED: Of the 605 participants, 432 (71.4 %) were male, 215 (35.5 %) were aged 25-34 years, 427 (70.6 %) had bacteriologically confirmed pulmonary TB, 133 (22.0 %) were undernourished and 398 (65.8 %) achieved treatment success. Of participants with bacteriologically confirmed pulmonary TB, 232 (59.0 %), 327 (59.3 %), and 360 (97.6 %) achieved sputum smear conversion at months 2, 5, and 6, respectively. Undernutrition reduced treatment success (RR 0.42, 95 % CI 0.32-0.55) as well as sputum smear conversion at months 2 (RR 0.45, 95 % CI 0.42-0.49) and 5 (RR 0.46, 95 % CI 0.43-0.51) but not month 6 (RR 0.99, 95 % CI 0.97-1.02).
UNASSIGNED: Undernutrition negatively impacts treatment outcomes. Therefore, nutritional assessment should be an integral component of TB care, with nutritional counseling and support offered to those undernourished to optimize their TB treatment response and outcomes.
摘要：
■营养不足与抗结核（TB）治疗反应和结核病治疗结果之间的因果关系研究不足。
■为了评估坎帕拉的再治疗药物敏感型结核病患者中营养不足对治疗成功和痰涂片转换的影响，乌干达。
■我们在2012年至2022年在坎帕拉接受治疗的年龄≥15岁的再治疗药物易感结核病患者中使用倾向评分加权进行了一项准实验研究。主要暴露是在结核病诊断时使用中上臂围评估的营养不足。主要结果是治疗成功，定义为6个月时治愈或治疗完成。痰涂片转换是次要结果，并在第2、5和6个月时测量痰涂片状态从阳性到阴性的变化。我们使用具有稳健误差方差的倾向评分加权修正泊松回归模型估计营养不足对结局的因果影响。
■在605名参与者中，432（71.4%）为男性，215人(35.5%)年龄在25-34岁之间，427例（70.6%）有细菌学证实的肺结核，133例（22.0%）营养不良，398例（65.8%）治疗成功。在细菌学证实为肺结核的参与者中，232（59.0%），327（59.3%），分别在第2、5和6个月时，有360例（97.6％）实现了痰涂片转换。营养不良降低了治疗成功率（RR0.42，95％CI0.32-0.55）以及第2个月（RR0.45，95％CI0.42-0.49）和第5个月（RR0.46，95％CI0.43-0.51）的痰涂片转换，但不是第6个月（RR0.99，95％CI0.97-1.02）。
■营养不良会对治疗结果产生负面影响。因此,营养评估应该是结核病护理的一个组成部分，向营养不良者提供营养咨询和支持，以优化他们的结核病治疗反应和结局。
■为了评估坎帕拉的再治疗药物敏感型结核病患者中营养不足对治疗成功和痰涂片转换的影响，乌干达。
■我们在2012年至2022年在坎帕拉接受治疗的年龄≥15岁的再治疗药物易感结核病患者中使用倾向评分加权进行了一项准实验研究。主要暴露是在结核病诊断时使用中上臂围评估的营养不足。主要结果是治疗成功，定义为6个月时治愈或治疗完成。痰涂片转换是次要结果，并在第2、5和6个月时测量痰涂片状态从阳性到阴性的变化。我们使用具有稳健误差方差的倾向评分加权修正泊松回归模型估计营养不足对结局的因果影响。
■在605名参与者中，432（71.4%）为男性，215人(35.5%)年龄在25-34岁之间，427例（70.6%）有细菌学证实的肺结核，133例（22.0%）营养不良，398例（65.8%）治疗成功。在细菌学证实为肺结核的参与者中，232（59.0%），327（59.3%），分别在第2、5和6个月时，有360例（97.6％）实现了痰涂片转换。营养不良降低了治疗成功率（RR0.42，95％CI0.32-0.55）以及第2个月（RR0.45，95％CI0.42-0.49）和第5个月（RR0.46，95％CI0.43-0.51）的痰涂片转换，但不是第6个月（RR0.99，95％CI0.97-1.02）。
■营养不良会对治疗结果产生负面影响。因此,营养评估应该是结核病护理的一个组成部分，向营养不良者提供营养咨询和支持，以优化他们的结核病治疗反应和结局。
