TY - JOUR
T1 - The effect of undernutrition on sputum culture conversion and treatment outcomes among people with multidrug-resistant tuberculosis
T2 - a systematic review and meta-analysis
AU - Wagnew, Fasil
AU - Alene, Kefyalew Addis
AU - Kelly, Matthew
AU - Gray, Darren
N1 - Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Not applicable. We thank the Australian National University library for offering us a wide range of available online databases. The authors additionally acknowledge Dr. Kerri Viney, of the Global Tuberculosis Programme, World Health Organization, Switzerland, who provided constructive and helpful comments during the development of this manuscript. FW: Conception of the research protocol, study design, quality assessment, data extraction, data analysis, interpretation, and drafting the manuscript. FW and KAA: study design, data extraction, quality assessment, data analysis, and reviewing and editing the manuscript. DG and MK: Interpretation of the data, reviewing and editing the manuscript. The manuscript has been read and approved by all the authors. All data generated or analyzed during this study are included in this article and its supplementary information files.
Publisher Copyright:
© 2022 The Authors
PY - 2023/2
Y1 - 2023/2
N2 - Objectives: We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multidrug-resistant tuberculosis (MDR-TB). Methods: We searched for publications in the Medline, Embase, Scopus, and Web of Science databases. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Hazard ratio (HR) for sputum culture conversion and odds ratio (OR) for end-of-treatment outcomes, with 95% CI, were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger's tests. Results: Of the 2358 records screened, 63 studies comprising a total of 31,583 people with MDR-TB were included. Undernutrition was significantly associated with a longer time to sputum culture conversion (HR 0.7, 95% CI 0.6-0.9, I2 = 67·1%), and a higher rate of mortality (OR 2.8, 95% CI 2.1-3.6, I2 = 21%) and unsuccessful treatment outcomes (OR 1.8, 95% CI 1.5-2.1, I2 = 70%). There was no significant publication bias in the included studies. Conclusion: Undernutrition was significantly associated with unsuccessful treatment outcomes, including mortality and longer time to sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardized TB drugs.
AB - Objectives: We aimed to evaluate the effect of undernutrition on sputum culture conversion and treatment outcomes among people with multidrug-resistant tuberculosis (MDR-TB). Methods: We searched for publications in the Medline, Embase, Scopus, and Web of Science databases. We conducted a random-effect meta-analysis to estimate the effects of undernutrition on sputum culture conversion and treatment outcomes. Hazard ratio (HR) for sputum culture conversion and odds ratio (OR) for end-of-treatment outcomes, with 95% CI, were used to summarize the effect estimates. Potential publication bias was checked using funnel plots and Egger's tests. Results: Of the 2358 records screened, 63 studies comprising a total of 31,583 people with MDR-TB were included. Undernutrition was significantly associated with a longer time to sputum culture conversion (HR 0.7, 95% CI 0.6-0.9, I2 = 67·1%), and a higher rate of mortality (OR 2.8, 95% CI 2.1-3.6, I2 = 21%) and unsuccessful treatment outcomes (OR 1.8, 95% CI 1.5-2.1, I2 = 70%). There was no significant publication bias in the included studies. Conclusion: Undernutrition was significantly associated with unsuccessful treatment outcomes, including mortality and longer time to sputum culture conversion among people with MDR-TB. These findings have implications for supporting targeted nutritional interventions alongside standardized TB drugs.
KW - MDR-TB
KW - Meta-analysis
KW - Sputum culture conversion
KW - Treatment outcomes
KW - Undernutrition
UR - http://www.scopus.com/inward/record.url?scp=85144948442&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2022.11.043
DO - 10.1016/j.ijid.2022.11.043
M3 - Article
C2 - 36481489
AN - SCOPUS:85144948442
SN - 1201-9712
VL - 127
SP - 93
EP - 105
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -
