Association between changes in body mass index and self-reported quality of life among patients successfully treated for tuberculosis disease in Tbilisi, Georgia Pubblico

Noah, Kameela (Spring 2022)

Permanent URL: https://etd.library.emory.edu/concern/etds/8p58pf461?locale=it
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Abstract

Objective: We aimed to estimate the association between changes in body mass index (BMI) during tuberculosis (TB) treatment with quality of life (QoL) at TB treatment completion.

Methods: We conducted a cross-sectional analysis using data from the Pulmonary Impairment after Tuberculosis Treatment (PITT) study. The PITT study was a cohort study conducted from 2019 to 2022 at the National Center for Tuberculosis and Lung Disease (NCTLD), Tbilisi, Georgia. Newly diagnosed adult (≥16 years) pulmonary TB patients with laboratory-confirmed TB who had BMI recorded at treatment initiation and completion were eligible for analyses. Weight gain was defined as ≥5% increase in BMI from the date of TB treatment initiation to date of completion. The 20-Item Short Form Survey (SF-20) was used to measure quality of life at treatment completion. Patients were defined to have high quality of life if physical (PCS) or mental composite scores (MCS) fell within the highest quartile. Crude and adjusted logistic regression models were used to estimate odds of high QoL.

Results: Among 124 eligible patients enrolled in PITT study, 119 (96.0%) were included in this study. Of these, 67 (56.3%) had ≥5% BMI increase. Among patients who experienced ≥5% BMI increase, 25% (13/52) had high PCS vs. 21% (14/67) among those with no BMI increase. The adjusted odds of reporting high PCS among patients who experienced ≥5% BMI increase were similar compared to those without BMI increase (aOR 1.5; 95% CI 0.6 – 4.0). Among patients who experienced ≥5% BMI increase, 23% (12/52) had high MCS vs. 25% (17/67) among those with no BMI increase. The adjusted odds of reporting higher MCS among patients who experienced ≥5% BMI increase was similar compared to those without BMI increase (aOR 0.9; 95% CI 0.4 – 2.0).

Conclusions: Compared to those with no BMI increase from the beginning to end of TB treatment, patients who had substantial BMI gain had similar odds of reporting high physical or mental QoL at the end of TB treatment.

Policy Implications: Weight gain, measured by increases in BMI from treatment initiation to completion, may not predict QoL at end of TB treatment.

Table of Contents

List of Figures i

List of Table ii

Introduction 1

Global Burden of Tuberculosis 1

Tuberculosis and Quality of Life 1

Tuberculosis and Body Mass Index 3

Study Objective and Aims 3

Methods 4

Settings and Study Design 4

Definitions 5

Statistical Analyses 7

Ethical Considerations 8

Results 8

Study Population 8

Patient Characteristics 8

Distribution of Quality of Life at Treatment Completion 9

Association between Relative Changes in Body Mass Index and Quality of Life 9

Total Composite Score 10

Total Physical Score 11

Total Mental Score 11

Smoking Status and Changes in Body Mass Index at Treatment Completion 12

Discussion 12

Conclusion 15

Public Health Significance 15

References 16

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