The Impact of Functional Performance, HIV Status, Malnutrition, and Clinical Features on Treatment Outcomes of Patients with Pulmonary Tuberculosis

Type Journal Article - Ethiopian Journal of Health Development
Title The Impact of Functional Performance, HIV Status, Malnutrition, and Clinical Features on Treatment Outcomes of Patients with Pulmonary Tuberculosis
Author(s)
Volume 14
Issue 2
Publication (Day/Month/Year) 2000
Page numbers 177-182
URL http://www.ajol.info/index.php/ejhd/article/viewFile/9918/31227
Abstract
We studied the influence of functional performance, clinical features, state of nutrition and HIV status at diagnosis on the outcome results of patients with pulmonary tuberculosis at a Yirga Alem Hospital in south Ethiopia. In prospective study, we investigated by functional, clinical, and nutritional methods 239 consecutive patients with pulmonary tuberculosis. Two hundred out of 239 (83.7%) patients were unable to work (KPS=<70) at first presentation. HIV positive tuberculosis patients had lower KPS (mean (SD) 56.2 (21.9)) than HIV negative tuberculosis patients (66.1 (13.4)) (Mann-Whitney test, p<0.013). The poor functional performance was significantly correlated with malnutrition as measured by low body mass index, low arm circumference and low body weight. The 26 admitted patients had a mean KPS of 49 compared with 67 among the other patients (Mann-Whitney test, p<0.001).Five out of 26 (19.2%) hospitalized patients died compared with seven of 124 (5.6%) of patients treated at the outpatients department (Fisher's exact test, p=0.04). Patients who died had a lower KPS than the other patients (Mann-Whitney test, p=0.045). Clinical features such as diarrhoea, skin disorders, neuropsychiatric impairment, and low Mantoux reactivity were significantly associated with a bad outcome of treatment. Our study concludes that some clinical features influence outcome of treatment with tuberculosis patients. However, the KPS is a better predictor to measure the need of health care than the outcome of treatment.

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