Abstract

Patients with Pulmonary tuberculosis (PTB) and hypocholesterolemia have an altered immune function, delayed sputum conversion at two months and increased mortality. However, the assessment for dyslipidemias is not often done in our setting. A cross-sectional study was conducted among adults at an urban TB clinic in Kampala, Uganda. We included different participants at diagnosis (0), 2, 5, 6 and 8 months of anti-TB treatment. Data was collected from a complete physical examination, a pre-tested structured questionnaire, six-hour fasting lipid profiles and random blood glucose levels. Of the 323 included participants, 63.5% (205/323) were males and the median age was 30 years, IQR (23-39). The prevalence of hypocholesterolemia was 43.65% (95% CI 38.3-49.2). The participants at diagnosis had the highest hypocholesterolemia prevalence, 57.3%, 95% CI (46.7-67.2); and lowest amongst those completing treatment at 6/8 months, 32.2%, 95% CI (21.6-45.2). Significant factors associated with hypocholesterolemia were: male gender (PR 1.52, 95% CI: 1.13-2.03), and duration of anti-TB treatment (0.88, 95% CI: 0.80-0.98). Hypocholesterolemia is common among patients with PTB. The risk of hypocholesterolemia increases with being male and reduces with increased duration of treatment. There is a need for further research in lipid abnormalities in TB patients.

Highlights

  • Pulmonary Tuberculosis (PTB) is still a major global health problem estimated to cause 10.4 million new casesAfrican Health SciencesAfrican Health Sciences Vol 18 Issue 3, September, 2018 cholesterolemia in Pulmonary tuberculosis (PTB) patients has been shown to alter the body immunity, and could possibly be associated with delayed sputum conversion and increased mortality especially in circumstances of drug resistance[5].Lipid abnormalities in PTB patients are associated with Anti-retroviral therapy (ART) especially Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) and Protease Inhibitors (PIs), HIV, malnutrition, cavitary disease on the X-ray and older age[6,7,8,9]

  • Male gender and duration of anti-tuberculosis treatment are associated with hypocholesterolemia in adult pulmonary tuberculosis patients in Kampala, Uganda

  • This paper, presents the prevalence and factors associated with hypocholesterolemia among adult PTB patients either at diagnosis, 2, 5 and 6 /8 months of anti-TB treatment at an urban out-patient clinic located in Kampala, Uganda

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Summary

Introduction

Pulmonary Tuberculosis (PTB) is still a major global health problem estimated to cause 10.4 million new casesAfrican Health SciencesAfrican Health Sciences Vol 18 Issue 3, September, 2018 cholesterolemia in PTB patients has been shown to alter the body immunity, and could possibly be associated with delayed sputum conversion and increased mortality especially in circumstances of drug resistance[5].Lipid abnormalities in PTB patients are associated with Anti-retroviral therapy (ART) especially Non-Nucleoside Reverse Transcriptase Inhibitors (NNRTIs) and Protease Inhibitors (PIs), HIV, malnutrition, cavitary disease on the X-ray and older age[6,7,8,9]. This paper, presents the prevalence and factors associated with hypocholesterolemia among adult PTB patients either at diagnosis, 2, 5 and 6 /8 months of anti-TB treatment at an urban out-patient clinic located in Kampala, Uganda. Patients with Pulmonary tuberculosis (PTB) and hypocholesterolemia have an altered immune function, delayed sputum conversion at two months and increased mortality. The participants at diagnosis had the highest hypocholesterolemia prevalence, 57.3%, 95% CI (46.7-67.2); and lowest amongst those completing treatment at 6/8 months, 32.2%, 95% CI (21.6-45.2). Significant factors associated with hypocholesterolemia were: male gender (PR 1.52, 95% CI: 1.13-2.03), and duration of anti-TB treatment (0.88, 95% CI: 0.80-0.98). Male gender and duration of anti-tuberculosis treatment are associated with hypocholesterolemia in adult pulmonary tuberculosis patients in Kampala, Uganda.

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