Impact of malnutrition on clinical presentation, clinical course, and mortality in MDR-TB patients

Epidemiol Infect. 2011 Jan;139(1):113-20. doi: 10.1017/S0950268810000907. Epub 2010 Apr 30.


Despite the adoption of strategies to prevent and treat multidrug-resistant tuberculosis (MDR-TB) over the past decade, Latvia continues to have one of the highest rates of MDR-TB in the world. It is important to identify modifiable factors that may impact on MDR-TB patient outcomes. A study was conducted to elucidate the association between nutritional status and clinical presentation, clinical course, and mortality in 995 adult patients treated for MDR-TB from 2000 to 2004. Twenty percent of patients were underweight, defined as a body mass index <18·5, at the time of diagnosis. These patients were significantly more likely to have clinical evidence of advanced disease, and had a greater risk of experiencing ≥3 side-effects [adjusted odds ratio 1·5, 95% confidence interval (CI) 1·1-2·1] and death (adjusted hazard ratio 1·9, 95% CI 1·1-3·5) compared to patients who were normal or overweight. Interventions aimed at these high-risk patients, including nutritional supplementation as an adjunct to anti-TB therapy, should be considered and evaluated by TB programmes.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Antitubercular Agents / pharmacology*
  • Drug Resistance, Multiple, Bacterial
  • Female
  • Humans
  • Latvia / epidemiology
  • Male
  • Malnutrition / complications*
  • Middle Aged
  • Mycobacterium tuberculosis / drug effects*
  • Odds Ratio
  • Retrospective Studies
  • Thinness / complications
  • Tuberculosis, Multidrug-Resistant / complications*
  • Tuberculosis, Multidrug-Resistant / epidemiology
  • Tuberculosis, Multidrug-Resistant / mortality*
  • Tuberculosis, Multidrug-Resistant / pathology
  • Young Adult


  • Antitubercular Agents