Abstract:

Objective: To explore the application effect of compound balanced nutrition powder in the anti-tuberculosis treatment on multidrug-resistant tuberculosis (MDR-TB) patients. Methods: From January 1, 2021 to June 30, 2023, MDR-TB patients admitted and treated to Nanning Fourth People’s Hospital were screened for nutritional risk with the NRS 2002 short form. Among 204 MDR-TB cases scoring ≥3, patient admission order was randomized in Excel (RAND function), 102 cases with odd numbers were assigned to the intervention group, and 102 cases with even numbers were assigned to the control group. After excluding lost-to-follow-up or treatment withdrawal cases, 98 patients in the intervention group and 92 patients in the control group were included in the analysis totally. After re-screening by a clinical nutritionist, controls received individualized nutritional assessment and diagnosis, daily caloric intake calculated and dietary counseling according to their degree of malnutrition. The intervention group received the same care plus a compound balanced nutrition powder. Nutritional intervention and anti-tuberculosis therapy proceeded concurrently in both groups. Relevant indicators and NRS 2002 scores were collected at four key time-points—1, 2, 3 and 6 months—to evaluate the effectiveness of the nutritional supplement in MDR-TB patients. Results: At 1 month, average serum albumin in the intervention group was (39.85±8.05) g/L vs. (37.22±7.42) g/L in controls, a difference that was statistically significant (t=-2.337, P=0.021). By 6 months, average total protein was 70.14±10.28 g/L in the intervention group and 72.87±7.43 g/L in controls; this difference was also significant (t=2.090, P=0.038). Sputum-smear and culture conversion rates consistently favored the intervention group: at 1 month 85.71% (84/98) vs. 75.00% (69/92) and 81.63% (80/98) vs. 70.65% (65/92), respectively (χ²=3.474,P=0.062;χ²=3.165, P=0.075); at 2 months 96.94% (95/98) vs. 92.39% (85/92) and 91.84% (90/98) vs. 88.04% (81/92)(χ²=1.968,P=0.161;χ²=0.759, P=0.384); and at 3 months both rates were 98.98% (97/98) for interventions group vs. 98.91% (91/92) for controls (χ²=0.002, P=0.964). At treatment completion, the care rate was 94.90% (93/98) in the intervention group, higher than the 89.13% (82/92) achieved by controls (χ²=2.171, P=0.141). Conclusion: The use of compound balanced nutrition powder as an adjuvant treatment can improve the nutritional status and clinical indicators of MDR-TB patients and to some extent increase the sputum conversion rate of MDR-TB patients, promoting their recovery.

Key words: Tuberculosis, multidrug-resistant, Nutritional support, Treatment outcome, Albumins