NUTRITIONAL STATUS AND ITS ASSOCIATION WITH TB TREATMENT OUTCOME AMONG PATIENTS ON ANTI-TB TREATMENT IN GARDO TB CENTER SOMALIA IN 2024; RETROSPECTIVE COHORT STUDY

Abstract

Background: Malnutrition is strongly linked to tuberculosis, acting as both a risk factor for developing the disease and a consequence of active infection. In Somalia, widespread food insecurity and limited access to healthcare further exacerbate this problem. However, there is limited evidence examining the association between nutritional status and TB treatment outcome. Assessing patients’ baseline nutritional status in relation to their treatment outcomes is crucial, as it can help inform targeted nutritional interventions that may significantly improve TB treatment success rates and overall patient recovery Objectives: To assess nutritional status and its association with Tuberculosis treatment outcome among patients on Anti-TB therapy at Gardo Tuberculosis treatment center 2024. Methods: A retrospective cohort study was conducted among 510 randomly selected individuals on anti tuberculosis treatment (260 malnourished and 250 well-nourished patients) at the Gardo Tuberculosis Center in Somalia. Patient data were extracted from medical records using a checklist based on national treatment guidelines and recording forms. Nutritional status was assessed using Body Mass Index (BMI), which was readily available in the patient cards. Differences in treatment outcomes (successful and unsuccessful) were calculated and compared between well-nourished and malnourished patients using proportions. Multiple logistic regression was fitted to control for confounding factors in the association between nutritional status and treatment outcomes, with a 5% significance level.. Results: A total of 924 patients were diagnosed with tuberculosis during the study period, of whom 421 were undernourished and 503 were well-nourished. Of these, 510 patients (260 well-nourished and 250 undernourished) were included in the assessment of tuberculosis treatment outcomes. Overall, 70.4% (95% CI: 66.2%–74.2%) of the patients achieved a successful treatment outcome. The treatment success rate was 58.0% (95% CI: 51.6%–63.7%) among undernourished individuals and 82.3% (95% CI: 78.5% 87.7%) among well-nourished individuals. The adjusted odds ratio indicated that being well-nourished at baseline was associated with significantly higher odds of achieving a successful tuberculosis treatment outcome (AOR = 4.0; 95% CI: 2.4–6.5). Conclusion: This study revealed that substantial proportion of patients at center were undernourished during treatment. Moreover well-nourished patients have higher chance of success after TB treatment indicating nutritional status is an important factor contributing to favorable treatment outcomes among tuberculosis patients. Integration of nutritional assessments and targeted interventions for under nutrition, should be prioritized within tuberculosis treatment frameworks to improve patient outcomes.