Anthropometric, nutritional and immunological indices of sputum culture converted MDR-TB patients after two months of anti-tuberculosis treatment: Implications for use as surrogate markers of sputum culture conversion.
EDEM V. Fabian, ARINOLA O. Ganiyu
Department of Immunology, University of Ibadan, Nigeria.
Consistent absence of Mycobacterium Tuberculosis bacilli in culture, known as sputum conversion, is a critical interim indicator of anti-TB treatment efficacy. However, there is need for more time saving and accessible surrogate measures for anti-TB treatment monitoring.
This study compared select anthropometric, plasma nutritional and immunologic factors of sputum culture-converted patients with non-converted patients as possible surrogates of sputum culture conversion in MDR-TB patients.
Fifty (50) consenting MDR-TB patients receiving anti-TB treatment were recruited for this study. Sputum culture was carried out monthly and sputum culture conversion was defined as two consecutive negative M.tb. cultures. At two months of treatment, percentage leucocyte migration(%LM), percentage nitrobluetetrazolium(%NBT), plasma levels of vitamins A, C, D and E, Interleukins(IL-) 6 and 8, hydrogen peroxide, nitric oxide, activities of superoxide dismutase, catalase and myeloperoxidase, body weight(BW), percentage body fat(PBF), waist circumference, hip circumference, body mass index(BMI), fat mass index(FMI) and fat-free mass index(FFMI) were assessed. Statistical significance was set at p<0.05.
At 2 months of anti-TB treatment, mean BW, BMI, PBF, FMI, FFMI and plasma vitamin D level were significantly higher while mean plasma vitamin E level was significantly lower in sputum culture converted patients compared with non-converted patients.
Sputum culture conversion in MDR-TB patients is associated with improved anthropometric indices, increased plasma vitamin D and intracellular killing mechanism.