Skip to main content
Top
Published in: BMC Public Health 1/2012

Open Access 01-12-2012 | Research article

Low nutrient intake among adult women and patients with severe tuberculosis disease in Uganda: a cross-sectional study

Authors: Ezekiel Mupere, Isabel M Parraga, Daniel J Tisch, Harriet K Mayanja, Christopher C Whalen

Published in: BMC Public Health | Issue 1/2012

Login to get access

Abstract

Background

Information regarding dietary nutrient intake during tuberculosis disease is lacking. We established the relationship between disease severity or wasting during pulmonary tuberculosis and nutrient intake.

Methods

In a cross-sectional study of 131 adults with or without pulmonary tuberculosis were screened for human immune-deficiency virus (HIV), wasting, disease severity using 13 item validated clinical TBscore, and 24-hour dietary intake recall.

Results

Of the 131 participants, 61 were males and 70 females. Overall men and women had similar age. In average 24-hour nutrient intake, the following nutrients: energy, protein, total fat, carbohydrate, calcium, vitamin A, and folate were low among patients with severe tuberculosis disease. Patients with moderate-to-severe clinical TBscore had lower average energy intake than patients with mild TBscores (6.11 vs. 9.27 MJ, respectively) (p<0.05). The average 24-hour nutrient intakes between wasted and non-wasted tuberculosis patients were comparable. Nutrient intake among men was higher when compared to women regardless of wasting and severity of tuberculosis. Among those with wasting, men had higher average energy intake than women (8.87 vs. 5.81 MJ, respectively) (p<0.05). Among patients with mild disease, men had higher average energy intake than women with mild disease (12.83 vs. 7.49 kcal, respectively) (p<0.001).

Conclusions

Findings suggest that severity of pulmonary tuberculosis and female gender had reduced nutrient intake. Early tuberculosis diagnosis and nutritional support may be important in management of tuberculosis patients.
Literature
1.
go back to reference Lawn SD, Churchyard G: Epidemiology of HIV-associated tuberculosis. Curr Opin HIV AIDS. 2009, 4 (4): 325-333. 10.1097/COH.0b013e32832c7d61. Epub 2009/06/18CrossRefPubMedPubMedCentral Lawn SD, Churchyard G: Epidemiology of HIV-associated tuberculosis. Curr Opin HIV AIDS. 2009, 4 (4): 325-333. 10.1097/COH.0b013e32832c7d61. Epub 2009/06/18CrossRefPubMedPubMedCentral
2.
go back to reference Lucas SB, De Cock KM, Hounnou A, Peacock C, Diomande M, Honde M, et al: Contribution of tuberculosis to slim disease in Africa. BMJ. 1994, 308 (6943): 1531-1533. 10.1136/bmj.308.6943.1531.CrossRefPubMedPubMedCentral Lucas SB, De Cock KM, Hounnou A, Peacock C, Diomande M, Honde M, et al: Contribution of tuberculosis to slim disease in Africa. BMJ. 1994, 308 (6943): 1531-1533. 10.1136/bmj.308.6943.1531.CrossRefPubMedPubMedCentral
3.
go back to reference Macallan DC: Malnutrition in tuberculosis. Diagn Microbiol Infect Dis. 1999, 34 (2): 153-157. 10.1016/S0732-8893(99)00007-3.CrossRefPubMed Macallan DC: Malnutrition in tuberculosis. Diagn Microbiol Infect Dis. 1999, 34 (2): 153-157. 10.1016/S0732-8893(99)00007-3.CrossRefPubMed
4.
go back to reference Zachariah R, Spielmann MP, Harries AD, Salaniponi FM: Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death. Trans R Soc Trop Med Hyg. 2002, 96 (3): 291-294. 10.1016/S0035-9203(02)90103-3.CrossRefPubMed Zachariah R, Spielmann MP, Harries AD, Salaniponi FM: Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death. Trans R Soc Trop Med Hyg. 2002, 96 (3): 291-294. 10.1016/S0035-9203(02)90103-3.CrossRefPubMed
5.
go back to reference Duarte EC, Bierrenbach AL, Barbosa da Silva J, Tauil PL, de Fatima Duarte E: Factors associated with deaths among pulmonary tuberculosis patients: a case–control study with secondary data. J Epidemiol Community Health. 2009, 63 (3): 233-238. 10.1136/jech.2008.078972. Epub 2008/12/11CrossRefPubMed Duarte EC, Bierrenbach AL, Barbosa da Silva J, Tauil PL, de Fatima Duarte E: Factors associated with deaths among pulmonary tuberculosis patients: a case–control study with secondary data. J Epidemiol Community Health. 2009, 63 (3): 233-238. 10.1136/jech.2008.078972. Epub 2008/12/11CrossRefPubMed
6.
go back to reference Saraceni V, King BS, Cavalcante SC, Golub JE, Lauria LM, Moulton LH, et al: Tuberculosis as primary cause of death among AIDS cases in Rio de Janeiro, Brazil. Int J Tuberc Lung Dis. 2008, 12 (7): 769-772. Epub 2008/06/12PubMedPubMedCentral Saraceni V, King BS, Cavalcante SC, Golub JE, Lauria LM, Moulton LH, et al: Tuberculosis as primary cause of death among AIDS cases in Rio de Janeiro, Brazil. Int J Tuberc Lung Dis. 2008, 12 (7): 769-772. Epub 2008/06/12PubMedPubMedCentral
7.
go back to reference Paton NI, Ng YM, Chee CB, Persaud C, Jackson AA: Effects of tuberculosis and HIV infection on whole-body protein metabolism during feeding, measured by the [15N]glycine method. Am J Clin Nutr. 2003, 78 (2): 319-325.PubMed Paton NI, Ng YM, Chee CB, Persaud C, Jackson AA: Effects of tuberculosis and HIV infection on whole-body protein metabolism during feeding, measured by the [15N]glycine method. Am J Clin Nutr. 2003, 78 (2): 319-325.PubMed
8.
go back to reference Khan A, Sterling TR, Reves R, Vernon A, Horsburgh CR: Lack of weight gain and relapse risk in a large tuberculosis treatment trial. Am J Respir Crit Care Med. 2006, 174 (3): 344-348. 10.1164/rccm.200511-1834OC. Epub 2006/05/20CrossRefPubMed Khan A, Sterling TR, Reves R, Vernon A, Horsburgh CR: Lack of weight gain and relapse risk in a large tuberculosis treatment trial. Am J Respir Crit Care Med. 2006, 174 (3): 344-348. 10.1164/rccm.200511-1834OC. Epub 2006/05/20CrossRefPubMed
9.
go back to reference Heitmann BL, Erikson H, Ellsinger BM, Mikkelsen KL, Larsson B: Mortality associated with body fat, fat-free mass and body mass index among 60-year-old swedish men-a 22-year follow-up. The study of men born in 1913. Int J Obes Relat Metab Disord. 2000, 24 (1): 33-37. 10.1038/sj.ijo.0801082. Epub 2000/03/07CrossRefPubMed Heitmann BL, Erikson H, Ellsinger BM, Mikkelsen KL, Larsson B: Mortality associated with body fat, fat-free mass and body mass index among 60-year-old swedish men-a 22-year follow-up. The study of men born in 1913. Int J Obes Relat Metab Disord. 2000, 24 (1): 33-37. 10.1038/sj.ijo.0801082. Epub 2000/03/07CrossRefPubMed
10.
go back to reference Kyle UG, Piccoli A, Pichard C: Body composition measurements: interpretation finally made easy for clinical use. Curr Opin Clin Nutr Metab Care. 2003, 6 (4): 387-393. Epub 2003/06/14PubMed Kyle UG, Piccoli A, Pichard C: Body composition measurements: interpretation finally made easy for clinical use. Curr Opin Clin Nutr Metab Care. 2003, 6 (4): 387-393. Epub 2003/06/14PubMed
11.
go back to reference VanItallie TB, Yang MU, Heymsfield SB, Funk RC, Boileau RA: Height-normalized indices of the body's fat-free mass and fat mass: potentially useful indicators of nutritional status. Am J Clin Nutr. 1990, 52 (6): 953-959. Epub 1990/12/01PubMed VanItallie TB, Yang MU, Heymsfield SB, Funk RC, Boileau RA: Height-normalized indices of the body's fat-free mass and fat mass: potentially useful indicators of nutritional status. Am J Clin Nutr. 1990, 52 (6): 953-959. Epub 1990/12/01PubMed
12.
go back to reference Schutz Y, Kyle UU, Pichard C: Fat-free mass index and fat mass index percentiles in Caucasians aged 18–98 y. Int J Obes Relat Metab Disord. 2002, 26 (7): 953-960. Epub 2002/06/25CrossRefPubMed Schutz Y, Kyle UU, Pichard C: Fat-free mass index and fat mass index percentiles in Caucasians aged 18–98 y. Int J Obes Relat Metab Disord. 2002, 26 (7): 953-960. Epub 2002/06/25CrossRefPubMed
13.
go back to reference Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al: Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998, 147 (8): 755-763. 10.1093/oxfordjournals.aje.a009520. Epub 1998/04/29CrossRefPubMed Baumgartner RN, Koehler KM, Gallagher D, Romero L, Heymsfield SB, Ross RR, et al: Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol. 1998, 147 (8): 755-763. 10.1093/oxfordjournals.aje.a009520. Epub 1998/04/29CrossRefPubMed
14.
go back to reference Kyle UG, Genton L, Pichard C: Body composition: what's new?. Curr Opin Clin Nutr Metab Care. 2002, 5 (4): 427-433. 10.1097/00075197-200207000-00012. Epub 2002/07/11CrossRefPubMed Kyle UG, Genton L, Pichard C: Body composition: what's new?. Curr Opin Clin Nutr Metab Care. 2002, 5 (4): 427-433. 10.1097/00075197-200207000-00012. Epub 2002/07/11CrossRefPubMed
15.
go back to reference World Health Organization: Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. 1995, Geneva: World Health Organ Tech Rep Ser, 1-452. 854 World Health Organization: Physical status: the use and interpretation of anthropometry. Report of a WHO Expert Committee. 1995, Geneva: World Health Organ Tech Rep Ser, 1-452. 854
16.
go back to reference Kotler DP, Burastero S, Wang J, Pierson RN: Prediction of body cell mass, fat-free mass, and total body water with bioelectrical impedance analysis: effects of race, sex, and disease. Am J Clin Nutr. 1996, 64 (3 Suppl): 489S-497S.PubMed Kotler DP, Burastero S, Wang J, Pierson RN: Prediction of body cell mass, fat-free mass, and total body water with bioelectrical impedance analysis: effects of race, sex, and disease. Am J Clin Nutr. 1996, 64 (3 Suppl): 489S-497S.PubMed
17.
go back to reference Van Lettow M, Kumwenda JJ, Harries AD, Whalen CC, Taha TE, Kumwenda N, et al: Malnutrition and the severity of lung disease in adults with pulmonary tuberculosis in Malawi. Int J Tuberc Lung Dis. 2004, 8 (2): 211-217.PubMed Van Lettow M, Kumwenda JJ, Harries AD, Whalen CC, Taha TE, Kumwenda N, et al: Malnutrition and the severity of lung disease in adults with pulmonary tuberculosis in Malawi. Int J Tuberc Lung Dis. 2004, 8 (2): 211-217.PubMed
18.
go back to reference Villamor E, Saathoff E, Mugusi F, Bosch RJ, Urassa W, Fawzi WW: Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis. Eur J Clin Nutr. 2006, 60 (2): 163-171. 10.1038/sj.ejcn.1602281.CrossRefPubMed Villamor E, Saathoff E, Mugusi F, Bosch RJ, Urassa W, Fawzi WW: Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis. Eur J Clin Nutr. 2006, 60 (2): 163-171. 10.1038/sj.ejcn.1602281.CrossRefPubMed
19.
go back to reference Mupere E, Zalwango S, Chiunda A, Okwera A, Mugerwa R, Whalen C: Body composition among HIV-seropositive and HIV-seronegative adult patients with pulmonary tuberculosis in Uganda. Ann Epidemiol. 2010, 20 (3): 210-216. 10.1016/j.annepidem.2009.11.001. Epub 2010/02/18CrossRefPubMedPubMedCentral Mupere E, Zalwango S, Chiunda A, Okwera A, Mugerwa R, Whalen C: Body composition among HIV-seropositive and HIV-seronegative adult patients with pulmonary tuberculosis in Uganda. Ann Epidemiol. 2010, 20 (3): 210-216. 10.1016/j.annepidem.2009.11.001. Epub 2010/02/18CrossRefPubMedPubMedCentral
20.
go back to reference Wejse C, Gustafson P, Nielsen J, Gomes VF, Aaby P, Andersen PL, et al: TBscore: Signs and symptoms from tuberculosis patients in a low-resource setting have predictive value and may be used to assess clinical course. Scand J Infect Dis. 2008, 40 (2): 111-120. 10.1080/00365540701558698. Epub 2007/09/14CrossRefPubMed Wejse C, Gustafson P, Nielsen J, Gomes VF, Aaby P, Andersen PL, et al: TBscore: Signs and symptoms from tuberculosis patients in a low-resource setting have predictive value and may be used to assess clinical course. Scand J Infect Dis. 2008, 40 (2): 111-120. 10.1080/00365540701558698. Epub 2007/09/14CrossRefPubMed
21.
go back to reference Swaminathan S, Padmapriyadarsini C, Sukumar B, Iliayas S, Kumar SR, Triveni C, et al: Nutritional status of persons with HIV infection, persons with HIV infection and tuberculosis, and HIV-negative individuals from southern India. Clin Infect Dis. 2008, 46 (6): 946-949. 10.1086/528860. Epub 2008/02/19CrossRefPubMed Swaminathan S, Padmapriyadarsini C, Sukumar B, Iliayas S, Kumar SR, Triveni C, et al: Nutritional status of persons with HIV infection, persons with HIV infection and tuberculosis, and HIV-negative individuals from southern India. Clin Infect Dis. 2008, 46 (6): 946-949. 10.1086/528860. Epub 2008/02/19CrossRefPubMed
22.
go back to reference Schluger NW, Rom WN: The host immune response to tuberculosis. Am J Respir Crit Care Med. 1998, 157 (3 Pt 1): 679-691. Epub 1998/03/28CrossRefPubMed Schluger NW, Rom WN: The host immune response to tuberculosis. Am J Respir Crit Care Med. 1998, 157 (3 Pt 1): 679-691. Epub 1998/03/28CrossRefPubMed
23.
go back to reference Arciero PJ, Goran MI, Poehlman ET: Resting metabolic rate is lower in women than in men. J Appl Physiol. 1993, 75 (6): 2514-2520. Epub 1993/12/01PubMed Arciero PJ, Goran MI, Poehlman ET: Resting metabolic rate is lower in women than in men. J Appl Physiol. 1993, 75 (6): 2514-2520. Epub 1993/12/01PubMed
24.
go back to reference Carloni AS: Sex disparities in the distribution of food within rural households. Food Nutr (Roma). 1981, 7 (1): 3-12. Epub 1981/01/01 Carloni AS: Sex disparities in the distribution of food within rural households. Food Nutr (Roma). 1981, 7 (1): 3-12. Epub 1981/01/01
25.
go back to reference de Hartog AP: Unequal distribution of food within the household: A somewhat neglected aspect of food behavior. FAO Nutritional Newletter. 1972, 10: 8-17. de Hartog AP: Unequal distribution of food within the household: A somewhat neglected aspect of food behavior. FAO Nutritional Newletter. 1972, 10: 8-17.
26.
go back to reference Holmboe-Ottesen G, Wandel M: Men's contribution to the food and nutritional situation in the Tanzanian household. Ecol Food Nutr. 1991, 26: 83-96. 10.1080/03670244.1991.9991191.CrossRef Holmboe-Ottesen G, Wandel M: Men's contribution to the food and nutritional situation in the Tanzanian household. Ecol Food Nutr. 1991, 26: 83-96. 10.1080/03670244.1991.9991191.CrossRef
27.
go back to reference Lado C: Female labour participation in agricultural production and the implications for nutrition and health in rural Africa. Soc Sci Med. 1992, 34 (7): 789-807. 10.1016/0277-9536(92)90366-X. Epub 1992/04/01CrossRefPubMed Lado C: Female labour participation in agricultural production and the implications for nutrition and health in rural Africa. Soc Sci Med. 1992, 34 (7): 789-807. 10.1016/0277-9536(92)90366-X. Epub 1992/04/01CrossRefPubMed
28.
go back to reference Rosenberg EM: Demographic effects of sex-differential nutrition. Nutritional anthropology: contemporary approaches to diet and culture. Edited by: Jerome JW, Kandel RF, Pelto GH. 1980, Pleasantville, NY: Redgrave Publishing, 181-203. Rosenberg EM: Demographic effects of sex-differential nutrition. Nutritional anthropology: contemporary approaches to diet and culture. Edited by: Jerome JW, Kandel RF, Pelto GH. 1980, Pleasantville, NY: Redgrave Publishing, 181-203.
29.
go back to reference Dey J: Gambian women: Unequal partners in rice development projects?. African women in the development process. Edited by: Nelson N. 1981, London: Frank Cass, 109-22. Dey J: Gambian women: Unequal partners in rice development projects?. African women in the development process. Edited by: Nelson N. 1981, London: Frank Cass, 109-22.
Metadata
Title
Low nutrient intake among adult women and patients with severe tuberculosis disease in Uganda: a cross-sectional study
Authors
Ezekiel Mupere
Isabel M Parraga
Daniel J Tisch
Harriet K Mayanja
Christopher C Whalen
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2012
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-12-1050

Other articles of this Issue 1/2012

BMC Public Health 1/2012 Go to the issue