The medical association between Tuberculosis (TB) and malnutrition is one that has been known for quite a while. In fact, both TB and malnutrition have been twin challenges affecting most underdeveloped countries of the world. Malnutrition makes people more susceptible to the development of active TB while active TB contributes to the development of malnutrition. This situation seems to affect more adult males in Kenya according to data from Tibu. Starting 2012, the National Tuberculosis, Leprosy and Lung Disease Program, embarked on implementing nutritional activities with the sole aim of improving treatment outcomes of those diagnosed with TB.
Notably, all individuals diagnosed with TB are subjected to an assessment of their nutritional status. This involves weight and height monitoring and calculation of body mass index for children above five 5 years, and Z Scores for children below 5 years
This has helped the NTLD-Program TB program measure the magnitude of under nutrition amongst TB patients in Kenya.
The nutrition status of TB patients is as shown below: (Annual Report 2015)
The high mortality and morbidity from TB in populations can be attributed to malnutrition mainly due to shortage of food.
Appropriate nutrition interventions are planned and implemented for patients according to their status in the following ways;-
- Continuous counselling and education based on individual nutritional status at diagnosis and throughout treatment. This may have an impact on treatment completion and success rates
- Therapeutic and supplemental nutrition therapy including vital Vitamin A.
In line with the community strategy referral and linkages mechanism, patients are referred to health facilities for care and support with follow up visits in the community. This has been made possible through capacity building of health care workers in TB clinics/treatment set ups supported under the Global Fund grant.
Despite all these efforts, the nutrition knowledge gap is still glaring. Treating TB while battling malnutrition is still a major challenge as nutrition therapy is expensive and many donors shy away from giving this type of support. Most of the patients suffer catastrophic effects due to food insecurity and poverty.
On a positive note however, the NTLD-Program has recently managed two extensively drug resistant TB (XDR-TB) invalid patients with very low BMIs (13.5 and 14.6) respectively and seen them improve to BMI >16 walking to survive treatment. Efforts to improve nutrition among TB patients works!