The impact of functional performance, HIV status, malnutrition, and clinical features on treatment outcomes of patients with pulmonary tuberculosis

Abstract

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 handred 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. [Ethiop. J. Health Dev. 2000;14(2):177-182]