Main Article Content
Tuberculosis (TB) is a leading cause of morbidity and mortality, especially in middle- and low-income countries. The risk of developing TB may be related to nutritional status. Socioeconomic and behavioral factors are also shown to increase the susceptibility to TB infection. The objective of this study was to determine nutritional factors as risk factors of pulmonary TB in adult.
This was an observational study of case control design. The study subjects were community members consisting of 19 adult cases of pulmonary tuberculosis and 38 controls. Data on nutritional intakes were obtained by semiquantitative food frequency questionnaire (FFQ), while smoking behavior, history of DM, body mass index, education, and income were obtained by structured interviews. The data were analyzed by independent t-test and logistic regression for calculation of the odds ratio (OR).
The bivariate test showed that the adequacy levels for energy (OR=6.8; 95% CI: 1.51-30.54), protein (OR=5.1; 95% CI: 1.52-17.14), vitamin A (OR=4.2; 5% CI: 1.31-13.54), vitamin C (OR=3.8;95% CI: 1.21-12.36), selenium (OR=4.2; 95% CI: 1.34-13.58), body mass index (OR=4.4; 95% CI: 1.32-14.35) and smoking behavior (OR=3.7; 95% CI: 1.15-11.9), were significant risk factors for pulmonary tuberculosis. Multiple logistic regression test showed that low body mass index (<18.5 kg/m2) (OR=6.0; 95% CI: 1.32-27.18) was a the most influential risk factor of pulmonary tuberculosis.
Low body mass index is the most influential risk factor for pulmonary tuberculosis incidence in adult. Nutrition profile in adult is an important determinant of TB incidence.
World Health Organization. Global tuberculosis report. Geneva: World Health Organization. 2014.
Kementerian Kesehatan Republik Indonesia. Riset kesehatan dasar (Riskesdas) tahun 2013. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.
Dinas Kesehatan Provinsi Jawa Tengah. Riset kesehatan dasar (Riskesdas) tahun 2013. Semarang: Dinas Kesehatan Provinsi Jawa Tengah; 2013.
Mulyadi, Suangkupon R, Dermawan I. Profil penderita tuberkulosis paru di pesisir pantai Aceh Barat Daya (Kajian di Puskesmas Biangpidie). J Respir Indones 2011;31:105-8.
Hatta M, Supriatmo, Ali M, et al. Comparison of zinc-probiotic combination therapy to zinc therapy alone in reducing the severity of acute diarrhea. Paediatrica Indonesiana 2011;51:1-6.
Manalu HS. Faktor-faktor yang mempengaruhi kejadian TB paru dan upaya penanggulangannya. J Ekologi Kesehatan 2010; 9:1340-4.
World Health Organization. Global tuberculosis control: surveillance, planning, financing. Report of WHO expert committee. WHO technical report series. Geneva: WHO;2007.
Narasimhan P, Wood J, Macintyre CR, et al. Risk factors for tuberculosis. Pulm Med 2013. Article ID 828939, 11 pages. http://dx.doi.org/10.1155/2013/828939.
Alavi-Naini R, Sharifi-Mood B, Maliheh M. Association between tuberculosis and smoking. Int J High Risk Behav Addict 2012;1:71-4.
Cegielski JP, McMurray DN. The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals. Int J Tuberc Lung Dis 2004;8:286-98.
Bhargava A, Chatterjee M, Jain Y, et al. Nutritional status of adult patients with pulmonary tuberculosis in rural central India and its association with mortality. PLoS ONE 2013;8:e77979. doi: 10.1371/journal.pone. 0077979.
Hardinsyah. Angka kecukupan energi, protein, lemak dan serat makanan. Prosiding Widyakarya Pangan dan Gizi VIII; 2004 Mei 17-19; Jakarta; 2004.p.323-27.
Gibson RS. Principles of nutritional assessment. 2nd ed. New York: Oxford University Press; 2005.
Maro I, Lahey T, MacKenzie T, et al. Low BMI and falling BMI predict HIV- associated with tuberculosis: a prospective study in Tanzania. Int J Tuberc Lung Dis 2010;14:1447–53.
Chen W, Shu W, Wang M, et al. Pulmonary tuberculosis incidence and risk factors in rural areas of China: a cohort study. PLoS ONE 2013;8:e58171. doi: 10.1371/journal.pone. 0058171.
Pakasi TA, Kariadi E, Wibowo Y, et al. Vitamin A deficiency and other factors associated with severe tuberculosis in Timor and Rote Islands, East Nusa Tenggara Province, Indonesia. Eur J Clin Nutr 2009:63:1130–5.
Dheda K, Schwander SK, Zhu B, et al. The immunology of tuberculosis: from bench to bedside. Respirology 2010;15:433-50.
Lombardo CC, Rina S, Visser ME. The nutritional status of patients with tuberculosis in comparison with tuberculosis-free contacts in Delft, Western Cape. S Afr J Clin Nutr 2012; 25:180-5.
Johnkennedy N, Onyinyechi AS, Chukwunyere NNE. The antioxidant status and lipid peroxidation product of newly diagnosed and 6 weeks follow up patients with pulmonary tuberculosis in Owerri, Imo state, Nigeria. Asian Pacific J Tropical Dis 2011;2:292-4.
Madhavi M, Samudram P, Kumar H, et al. Effect of antioxidant vitamins C dan E supplementation on its plasma levels and on lipid profile in pulmonary tuberculosis patients. Am J Infect Dis 2009;5:263-72.
Zakiyyah ER, Gurnida DA, Kartasasmita CB. Pengaruh pemberian vitamin C terhadap perubahan kadar total antioksidan serum pada penderita tuberkulosis paru. Sari Pediatri 2014; 16:2-7.
Ramakrishnan K, Sharma SP, Shenbagarathai R, et al. Serum selenium levels in pulmonary tuberculosis levels with and without HIV/AIDS. Retrovirology 2009;6:P76. doi: 10.1186/1742-4690-6-S2-P76.
Seyedrezazadeh E, Ostadrahimi A, Mahboob S, et al. Effect of vitamin E and selenium supplementation on oxidative stress status in pulmonary tuberculosis patients. Respirology 2008;13:294-98. doi: 10.1111/j.1440-1843. 2007.01200.x.
Gupta KB, Gupta R, Atreja A, et al. Tuberculosis and nutrition. Lung India 2009;26: 9-16.
Wijaya AA. Merokok dan tuberkulosis. J Tuberculosis Indones 2012;8:18-23.
Leung CC, Lam TH, Ho KS, et al. Passive smoking and tuberculosis. Arch Intern Med 2010;170:287-92.