Prevalence of undernutrition and Associated Factors among Adult Tuberculosis Patients in Public Health Facilities in Dire Dawa Administration in Ethiopia a cross-sectional Study

Abstract

Background: The prevalence of under nutrition among TB patients remains above 20% for 14 of the 30 high TB-burden countries. One of the main issues facing TB patients in the world's developing nations. Two out of every three TB patients who were registered in Ethiopia in 2015 were undernourished, despite the national TB treatment guidelines and the World Health Organization (WHO) recommendation for nutrition assessment and counseling, management of malnutrition, and supplementation of micronutrient services for TB patients. Therefore, this study aimed to determine the extent of undernutrition and associated factors among adult TB patients at public health facilities in Dire Dawa administration, Eastern Ethiopia.

Methods: An institutional-based cross-sectional study was conducted in Dire Dawa administrative public health facilities from October 15 to November 15, 2020, among 402 adult TB patients. The study participants were allocated to the selected health facilities proportional to their size and study participants were consecutively enrolled in the study during the study period. Measuring height and weight should be done at TB OPD taken by height measuring board and digital bath balance, Seca, which is the German model for weight measurement was used by trained data collectors. The collected data were entered into Epi-data version 3.3 and then was exported to SPSS version 25. To determine the variables associated to under nutrition among TB patients, bivariate and multivariate logistic regression analyses were conducted. Statistical significance was declared at P<0.05.

Results: The prevalence of under nutrition was 44.5% of adult TB patients (95% CI = 39%-49.4%). Age >= 55 years and above (AOR=0.15,95%CI:0.043-0.504); no source of monthly income with (AOR = 2.67, 95% CI: 1.409-5.037) and <= 1500 Ethiopian Birr ( ETB) (AOR=2.13, 95% CI: 1.256-3.609); family size > four and above (AOR = 2.21, 95% CI: 1.363-3.572); ambulatory patients (AOR = 2.26, 95% CI: 1.403-3.640), and bedridden (AOR = 3.60, 95% CI: 1.724 -7.499); not receiving dietary counseling (AOR=2.63, 95% CI: 1.616-4.288) ;and not tested sputum smear (AOR=0.34,95%CI:0.185- 0.617) were the predictors of under nutrition among TB patients. Regular screening of nutritional status, provision of nutrition support, stabilization, and strengthening dietary counseling and care an integral components of TB treatment necessary for better treatment outcomes and recovery with the collaboration of other stakeholders, and non-governmental organizations.

Conclusion: The prevalence of undernutrition was lower than the pooled prevalence of undernutrition among TB patients in Ethiopia. TB screening and diagnosis, as well as regardless of regular nutritional assessment, strengthening of dietary counseling, and provision of nutritional support, are therefore required for improved treatment outcomes in an effective TB management program.