Dietary counseling adherence during tuberculosis treatment: A longitudinal study

Abstract

Background: The World Health Organization (WHO) recommends the use of dietary counseling to overcome malnutrition for patients with tuberculosis, with or without HIV, however the response to nutritional treatment depends on patient's adherence to nutritional counseling.

Objective: Identify the degree of adherence to dietary counseling and predictors of adherence among patients undergoing tuberculosis treatment.

Design: Observational prospective follow-up study conducted in adults treating for tuberculosis with or without HIV. Self-reported adherence and 24-h diet recall were checked. Diet counseling according to WHO strategy was offered at each visit for all patients. The endpoint was the adherence to the recommended dietary allowance (RDA) and total calories consumed during tuberculosis treatment. Data were mainly analyzed with marginal models to estimate adjusted trajectories.

Results: Sixty-eight patients were included in the study. The maximum probability of total calories consumption of at least one RDA was 80%. The adherence to dietary counseling was low regardless of HIV infection. The negative determinants of adherence were the presence of loss of appetite and nausea/vomiting. For patients with loss of appetite and nausea/vomiting, the probability of total calories consumption of at least one RDA is less than 20% at any time.

Conclusion: The loss of appetite and nausea/vomiting are highly prevalents and were the main causes of non-adherence to dietary counseling.

Keywords: Adherence; Compliance; Dietary counseling; HIV; Nutrition; Tuberculosis.