Association of body mass index, hand grip strength and quality of life with response to anti-tubercular therapy in adult patients of pulmonary and extra-pulmonary tuberculosis
Keywords:Tuberculosis, BMI, HGS, WHOQOL-BREF, ATT
Background: Monitoring of anti-tubercular therapy (ATT) response necessary for successful completion of ATT regimen. Presently available monitoring tools are invasive and have limitations. This study undertaken to see whether non-invasive tools like body mass index (BMI), hand grip strength (HGS) and quality of life (QOL) can serve as a reliable tool for monitoring ATT response.
Methods: The 50 patients of tuberculosis were monitored for BMI, HGS and QOL via WHOQOL-BREF questionnaire and analyzed at baseline, 2 months and 6 months of starting ATT.
Results: BMI HGS increased significantly at 2 months and 6 months compared to baseline with ATT. Physical and social domain of WHOQOL-BREF increased at 2 and 6 months with ATT, other domains shown no significant changes.
Conclusions: Monitoring of BMI, handgrip strength and QOL can be a cost-effective tool for monitoring ATT response, both in pulmonary and extra pulmonary tuberculosis.
Central TB division Directorate General of Health Services, India TB report 2018. Ministry of Health and Family Welfare: New Delhi, India. 2018.
Van-Crevel R, Karyadi E, Netea MG. Decreased plasma leptin concentrations in tuberculosis patients are associated with wasting and inflammation. J Clin Endocrinol Metab. 2002;87:758-63.
Van-Lettow M, Van-der Meer JW, West CE. Interleukin-6 and human immunodeficiency virus load, but not plasma leptin concentration, predict anorexia and wasting in adults with pulmonary tuberculosis in Malawi. J Clin Endocrinol Metab. 2005;90:4771-6.
Walzl G, Ronacher K, Hanekom W. Immunological biomarkers of tuberculosis. Nat Rev Immunol. 2011;11:343-54.
Bohannon RW. Hand-grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther. 2008;31:3-10.
Letrait M, Laurie A, Bean K. The asthma impact record (AIR) index: a rating scale to evaluate the quality of life of asthmatic patients in France. Eur Resp J. 1996;9:1163.
Saxena S, Chandiramani K, Bhargava R. WHOQOL-Hindi: A questionnaire for assessing quality of life in health care settings in India. World Health Organization Quality of Life. Natl Med J India. 1998;11:160-5.
Sathvik BS, Parthasarathi G, Narahari MG. An assessment of the quality of life in hemodialysis patients using the WHOQOL-BREF questionnaire. Indian J Nephrol. 2008;18:141-9.
Praygod G, Range N, Faurholt-Jepsen. Weight, Body Composition and Hand grip Strength among Pulmonary Tuberculosis Patients: A Matched Cross-Sectional Study in Mwanza, Tanzania. Trans R Soc Trop Med Hyg. 2011;105:140-7.
Martins N, Morris P, Kelly P. Food Incentives to Improve Completion of Tuberculosis Treatment: Randomized Controlled Trial in Dili, Timor-Leste. Bri Med J. 2009;339b:42-8.
Skevington SM, Lotfy M, O’Connell KA. WHOQOL Group. The World Health Organization's WHOQOL-BREF quality of life assessment: Psychometric properties and results of the international field trial. A report from the WHOQOL group. Qual Life Res. 2004;13:299-310.
Mears DC, Velyvis JH, Chang CP. Displaced acetabular fractures managed operatively: Indicators of outcome. Clin Orthop Relat Res. 2003;173-86.
Pacian A, Kulik TB, Pacian J, Chrusciel P, Zolnierczuk-Kieliszek D, Jarosz MJ. Psychosocial aspect of quality of life of Polish women with breast cancer. Ann Agric Environ Med. 2012;19:509-12.
Khosravi A, Ramezani MA, Toghianifar N, Rabiei K, Jahandideh M, Yousofi A. Association between hypertension and quality of life in a sample of Iranian adults. Acta Cardiol. 2010;65:425-30.
De Oliveira, PP, Sandrin CC, Batista PH, Marinheiro LP, Wender, MC, Roisenberg F. Relationship between quality of life and vertebral fracture in older women living in Southern Brazil. Rev Bras Ginecol Obstet. 2011;33:231-7.
Rajeswari R, Balasubramanian R, Muniyandi M, Geetharamani S, Thresa X, Venkatesan P. Socio-economic impact of tuberculosis on patients and family in India. Int J Tuberc Lung Dis. 1999;3(10):869-77.
Liefooghe R, Michiels N, Habib S, Moran MB, De Muynck A. Perception and social consequences of tuberculosis: a focus group study of tuberculosis patients in Sialkot, Pakistan. Soc Sci Med. 1995;41(12):1685-92.
Guyatt GH, King DR, Feeny DH, Stubbing D, Goldstein RS. Generic and specific measurement of health-related quality of life in a clinical trial of respiratory rehabilitation. J Clin Epidemiol. 1999;52(3):187.
Harries AD, Nkhoma WA, Thompson PJ, Nyangulu DS, Wirima JJ. Nutritional status in Malawian patients with pulmonary tuberculosis and response to chemotherapy. Eur J Clin Nutr. 1988;42:445-50.
Kennedy N, Ramsay A, Uiso L, Gutmann J, Ngowi FI, Gillespie SH. Nutritional status and weight gain in patients with pulmonary tuberculosis in Tanzania. Trans R Soc Trop Med Hyg. 1996;90:162-6.
Wen CP, David Cheng TY, Tsai SP. Are Asians at greater mortality risks for being overweight than caucasians? Redefining obesity for Asians. Public Health Nutr. 2009;12:497-506.
De Reus YA, Beek LT, Werf TSVD, Akkerman OW. Changes in body composition and strength during initial treatment in malnourished patients with tuberculosis. Eur Resp J. 2019;PA5277.
White LV, Lee N, Marin FP, Saludar NR, Edwards T, Cox SE. Performance of alternative measures to body mass index in the assessment of moderate and severe under-nutrition among acutely unwell patients hospitalized in a TB ward in the Philippines: A cross-sectional study. PLoS one. 2019;14(5):e0215968.
Bauer M, Leavens A, Schwartzman K. A systematic review and meta-analysis of the impact of tuberculosis on health-related quality of life. Qual Life Res. 2013;22(8):2213-35.
Chamla D. The assessment of patients' health-related quality of life during tuberculosis treatment in Wuhan, China. Int J Tuberc Lung Dis. 2004;8(9):1100-6.
Dhuria M, Sharma N, Ingle G. Impact of tuberculosis on the quality of life. Ind. J Comm. Med, 2008;33(1):58-9.
Chung WS, Lan YL, Yang MC. Psychometric testing of the short version of the world health organization quality of life (WHOQOL-BREF) questionnaire among pulmonary tuberculosis patients in Taiwan. BMC Pub Health. 2012;12:630.
Kastien-Hilka T, Abulfathi A, Rosenkranz B, Bennett B, Schwenkglenks M, Sinanovic E. Health-related quality of life and its association with medication adherence in active pulmonary tuberculosis- a systematic review of global literature with focus on South Africa. Health Qual Life Outcomes. 2016;14:42.
Rajeswari R, Muniyandi M, Balasubramanian R, Narayanan PR. Perceptions of tuberculosis patients about their physical, mental and social well-being: a field report from south India. Soc Sci Med. 2005;60(8):1845-53.
Dar SA, Shah NN, Wani ZA, Nazir D. A prospective study on quality of life in patients with pulmonary tuberculosis at a tertiary care hospital in Kashmir, Northern India. Ind J Tuberc. 2019;66(1):118-22.
Dujaili JA, Sulaiman SA, Hassali MA, Awaisu A, Blebil AQ, Bredle JM. Health related quality of life as a predictor of tuberculosis treatment outcomes in Iraq. Int J Infect Dis. 2015;31:4-8.
Jaber AA, Khan AH, Syed Sulaiman SA, Ahmad N, Anaam MS. Evaluation of health-related quality of life among tuberculosis patients in two cities in yemen. PLoS One. 2016;11(6):e0156258.
Maguire GP, Anstey NM, Ardian M, Waramori G, Tjitra E, Kenangalem E. Pulmonary tuberculosis, impaired lung function, disability and quality of life in a high-burden setting. Int J Tuberc Lung Dis. 2009;13(12):1500-6.
Atif M, Sulaiman SA, Shafie AA, Asif M, Sarfraz MK, Low HC. Impact of tuberculosis treatment on health-related quality of life of pulmonary tuberculosis patients: a follow-up study. Health Qual Life Outcomes. 2014;12:19.
Babikako HM, Neuhauser D, Katamba A, Mupere E. Feasibility, reliability and validity of health-related quality of life questionnaire among adult pulmonary tuberculosis patients in urban Uganda: cross-sectional study. Health Qual Life Outcomes. 2010;8:93.
Kisaka SM, Rutebemberwa E, Kasasa S, Ocen F, Nankya-Mutyoba J. Does health related quality of life among adults with pulmonary tuberculosis improve across the treatment period? A hospital-based cross- sectional study in Mbale Region, Eastern Uganda. BMC Res Notes. 2016;9(1):467.
Kastien-Hilka T, Rosenkranz B, Sinanovic E, Bennett B, Schwenkglenks M. Health related quality of life in South African patients with pulmonary tuberculosis. PLoS One. 2017;12(4):e0174605.
Louw JS, Mabaso M, Peltzer K. Change in health-related quality of life among pulmonary tuberculosis patients at primary health care settings in South Africa: a prospective cohort study. PLoS One. 2016;11(5):e0151892.
Unalan D, Soyuer F, Ceyhan O, Basturk M, Ozturk A. Is the quality of life different in patients with active and inactive tuberculosis? Indian J Tuberc. 2008;55(3):127-37.
Duyan V, Kurt B, Aktas Z, Duyan GC, Kulkul DO. Relationship between quality of life and characteristics of patients hospitalized with tuberculosis. Int J Tuberc Lung Dis. 2005;9(12):1361-6.