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 Table of Contents  
ORIGINAL ARTICLE
Year : 2020  |  Volume : 4  |  Issue : 2  |  Page : 141-142

Incidence of tuberculosis among malnourished patients: A summary on epidemiological data from a rural province in indochina


1 Medical Center, Bangkok, Thailand
2 Department of Community Medicine, Dr DY Patil University, Pune, Maharashtra, India; Department of Biological Science, Joseph Ayo Babalola University, Osun State, Nigeria

Date of Submission05-Sep-2019
Date of Acceptance07-Oct-2019
Date of Web Publication17-Jun-2020

Correspondence Address:
Dr. Rujittika Mungmunpuntipantip
26 Medical Center, Bangkok
Thailand
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bbrj.bbrj_130_19

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  Abstract 


Background: In developing countries, malnutrition is a common public health problem. In the same setting, infectious diseases including tuberculosis are also common. The interrelationship between malnutrition and tuberculosis is mentioned in literature. Malnourished patients are proposed to be a risk group prone to tuberculosis infection. Methods: In this report, the authors retrospectively analyzed the available epidemiological data regarding tuberculosis among malnourished patients in a rural province of Thailand, a tropical country in Indochina. Results: According to this study, the incidence of tuberculosis among malnourished patients is equal to 0.65% (95% confidence interval = 0.09%–4.8%). Conclusion: The incidence of tuberculosis among patients with malnutrition status is high in our setting. Screening for tuberculosis among malnourished patients is useful.

Keywords: Indochina, malnutrition, screening, tuberculosis


How to cite this article:
Mungmunpuntipantip R, Wiwanitkit V. Incidence of tuberculosis among malnourished patients: A summary on epidemiological data from a rural province in indochina. Biomed Biotechnol Res J 2020;4:141-2

How to cite this URL:
Mungmunpuntipantip R, Wiwanitkit V. Incidence of tuberculosis among malnourished patients: A summary on epidemiological data from a rural province in indochina. Biomed Biotechnol Res J [serial online] 2020 [cited 2020 Jul 7];4:141-2. Available from: http://www.bmbtrj.org/text.asp?2020/4/2/141/286839




  Introduction Top


In developing countries, health problems are usually common. The local people living in poor developing countries usually have health problem. Poor nutritional status is a common health problem seen in developing countries around the world.[1] Malnourished patients usually have poor physiological status and impaired immunity. Therefore, they usually have other co-existing health problems.[2]

In developing countries, infectious diseases are also common. Many communicable diseases including tuberculosis are endemic in several developing countries around the world. Malnutrition might associate with infectious diseases in several ways.[3] The alteration of the immune system and physiological defense due to malnutrition can contribute to increased risk of many infections.[3] If one has malnutrition, the impaired immune function is detectable.[3] The concurrence between tuberculosis and malnutrition is possible.[4] The interrelationship between malnutrition and tuberculosis is mentioned in literature.[4] Malnourished patients are proposed to be a risk group prone to tuberculosis infection.

In the present report, the authors retrospectively analyzed the available epidemiological data regarding tuberculosis among malnourished patients in a rural province of Thailand, a tropical country in Indochina. The high incidence of tuberculosis among malnourished patients is observable.


  Methods Top


This work is a retrospective study on the public available data. The available data regarding active tuberculosis screening among patients with malnutrition problem (defined as body mass index <18.5 kg/m2) in a rural province namely Beungkarn province of Thailand, a tropical country in Southeast Asia in the year 2018, are the primary data. The study setting is a rural province of Thailand with international border with Lao, another Indochina country [Figure 1], and has the number of local population at about 420,000. The data on the tuberculosis screening result are reappraised and analyzed for incidence rate along with range (95% confidence interval [CI]). Descriptive statistical analysis was used where appropriate. The present work is a retrospective analysis on public available data and does not directly involve human or animal subjects; therefore, it requires no written informed consent or ethical approval [Figure 1].
Figure 1: Map of Beungkarn province, Thailand

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  Results Top


According to the records, there are 154 patients with malnutrition problem in the studied setting. All received active screening for tuberculosis (X-ray, microbiology and molecular diagnostic tests for tuberculosis) and one had diagnosis of tuberculosis. The incidence rate was equal to 0.65% (95% CI = 0.09%–4.8%).


  Discussion Top


Tuberculosis is a common problem in Southeast Asia including Thailand.[5] The high incidence rate among the local population (about 180/100,000; data according to the Thai Ministry of Public Health) in Thailand has been documented. In the present report, the authors retrospectively analyzed the data from the results of active tuberculosis screening program in a rural province of Thailand. Among the patients with malnutrition, which is an important group prone to tuberculosis infection, the incidence of tuberculosis was very high. The detected incidence was up to 650/100,000 which is about 3.6 times of the general population. Indeed, a high incidence of tuberculosis is reported among the patients with malnutrition. In a recent report, 25.6% of HIV-infected patients with malnutrition had tuberculosis.[6]

Malnourished patients generally have poor health status and impaired immunity.[2] Patients are susceptible to superimposed infections including tuberculosis. Narasimhan et al. noted that malnutrition is one of the important risk factors for tuberculosis.[7] On the other hand, tuberculosis might be latent and lead to malnutrition.[8] The existence of tuberculosis in hospitalized patients with severe malnutrition also relates to the high mortality.[9] Hence, there is a strong interrelationship between tuberculosis and malnutrition. When a practitioner manages a case with malnutrition, it is wise to think about the hidden tuberculosis infection. Screening for tuberculosis among patients with malnutrition status is recommended. On the other hand, the nutritional assessment should also be levied on any patients with tuberculosis.[10] In addition, integrative therapy approach including nutritional supplement should be considered in the management of patients with tuberculosis.[11] A good nutritional supplementation is proven useful in caring patients with tuberculosis.[11]


  Conclusion Top


The incidence of tuberculosis among patients with malnutrition status is high in our setting. Screening for tuberculosis among malnourished patients should be performed in any area with high prevalence of tuberculosis.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Prendergast AJ, Humphrey JH. The stunting syndrome in developing countries. Paediatr Int Child Health 2014;34:250-65.  Back to cited text no. 1
    
2.
Ibrahim MK, Zambruni M, Melby CL, Melby PC. Impact of childhood malnutrition on host defense and infection. Clin Microbiol Rev 2017;30:919-71.  Back to cited text no. 2
    
3.
Farhadi S, Ovchinnikov RS. The relationship between nutrition and infectious diseases: A review. Biomed Biotechnol Res J 2018;2:168-72.  Back to cited text no. 3
  [Full text]  
4.
Cegielski JP, McMurray DN. The relationship between malnutrition and tuberculosis: Evidence from studies in humans and experimental animals. Int J Tuberc Lung Dis 2004;8:286-98.  Back to cited text no. 4
    
5.
Colebunders R, Apers L, Dieltiens G, Worodria W. Tuberculosis in resource poor countries. BMJ 2007;334:105-6.  Back to cited text no. 5
    
6.
Adler H, Archary M, Mahabeer P, LaRussa P, Bobat RA. Tuberculosis in HIV-infected South African children with complicated severe acute malnutrition. Int J Tuberc Lung Dis 2017;21:438-45.  Back to cited text no. 6
    
7.
Narasimhan P, Wood J, Macintyre CR, Mathai D. Risk factors for tuberculosis. Pulm Med 2013;2013:828939.  Back to cited text no. 7
    
8.
Kant S, Gupta H, Ahluwalia S. Significance of nutrition in pulmonary tuberculosis. Crit Rev Food Sci Nutr 2015;55:955-63.  Back to cited text no. 8
    
9.
Munthali T, Chabala C, Chama E, Mugode R, Kapata N, Musonda P, et al. Tuberculosis caseload in children with severe acute malnutrition related with high hospital based mortality in Lusaka, Zambia. BMC Res Notes 2017;10:206.  Back to cited text no. 9
    
10.
Miyata S, Tanaka M, Ihaku D. Usefulness of the malnutrition screening tool in patients with pulmonary tuberculosis. Nutrition 2012;28:271-4.  Back to cited text no. 10
    
11.
Jena L, Harinath BC. Anti-tuberculosis therapy: Urgency for new drugs and integrative approach. Biomed Biotechnol Res J 2018;2:16-9.  Back to cited text no. 11
  [Full text]  


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