Weight Gain and Response to Treatment for Multidrug-Resistant Tuberculosis

Ma Tarcela Gler Tropical Disease Foundation, Makati City, Philippines; Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia; Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

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Ruffy Guilatco Tropical Disease Foundation, Makati City, Philippines; Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia; Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

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Janice C. Caoili Tropical Disease Foundation, Makati City, Philippines; Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia; Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

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Julia Ershova Tropical Disease Foundation, Makati City, Philippines; Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia; Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

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Peter Cegielski Tropical Disease Foundation, Makati City, Philippines; Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia; Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

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John L. Johnson Tropical Disease Foundation, Makati City, Philippines; Division of TB Elimination, Centers for Disease Control and Prevention, Atlanta, Georgia; Tuberculosis Research Unit, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, Ohio

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Alternatives to culture are needed in high burden countries to assess whether response to treatment of multidrug-resistant-tuberculosis (MDR-TB) is satisfactory. The objective was to assess the association of weight gain and treatment outcome. The methods included analysis of clinical, bacteriologic, and weight from 439 MDR-TB patients in the Philippines. Odds ratios (ORs) were calculated to determine whether 5% weight gain during the first 6 months of treatment was associated with outcome. Three hundred and ten (71%) patients were cured and 129 (29%) had poor outcomes (death, defaulted, or failed treatment). Fifty-three percent were underweight (body mass index [BMI] < 18.5 kg/m2) before treatment. Five percent weight gain after completing 3 months of treatment was associated with good outcome among patients who were underweight before treatment (OR 2.1; 95% confidence interval [CI], 1.05 to 4.4). Baseline weight and degree of weight change during the first 6 months of treatment can help identify persons who are more likely to have poor outcomes and require other interventions.

Author Notes

* Address correspondence to Maria Tarcela S. Gler, Makati Medical Center, Rm 336B, #2 Amorsolo St, Makati City, Philippines 1229. E-mail: tarcelasg@yahoo.com

Authors' addresses: Ma Tarcela Gler, Ruffy Guilatco, and Janice C. Caoili, Tropical Disease Foundation, PMDT, Makati City, Metro Manila, Philippines, E-mails: tarcelasg@yahoo.com, rsguilatco@gmail.com, and janice.caoili@gmail.com. Julia Ershova and Peter Cegielski, Centers for Disease Control and Prevention, Division of TB Elimination, Atlanta, GA, E-mails: jhe3@cdc.gov and gzc2@cdc.gov. John L. Johnson, Case Western Reserve University School of Medicine, Tuberculosis Research Unit, Department of Medicine, Cleveland, OH, E-mail: jlj@case.edu.

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