Assessment of Dietary Intake and Body Mass Index among Tuberculosis Patients Receiving Anti-tuberculosis Treatment in Namibia: A Cross-Sectional Study
M. Musuuo *
Preventative Health Science Department, Namibia University of Science and Technology, Private Bag 13388, Windhoek, Namibia.
O. Awofolu
Preventative Health Science Department, Namibia University of Science and Technology, Private Bag 13388, Windhoek, Namibia.
*Author to whom correspondence should be addressed.
Abstract
Background: Tuberculosis (TB) remains a major global public health problem. It is strongly associated with undernutrition, which adversely affects immune function, disease progression and treatment outcomes. Although the role of nutrition in the management of TB is well recognised, evidence on dietary intake and the nutritional status of patients with TB in Namibia remains limited.
Aim: This study aimed to assess dietary intake and body mass index (BMI) among patients with TB receiving anti-tuberculosis treatment in Namibia.
Methods: A descriptive cross-sectional study was conducted among 111 patients with TB receiving anti-tuberculosis treatment at Katutura, Havana and Okuryangava Health Centres from September 2022 to March 2023. Dietary intake was assessed using a two-day, interviewer-administered 24-hour dietary recall, and anthropometric measurements were used to determine BMI according to World Health Organization classifications. Nutrient intake was analysed using Cronometer software, and the data were analysed using IBM SPSS Statistics version 27. Descriptive statistics, Pearson's correlation analysis and chi-square tests were performed, with statistical significance set at p < 0.05.
Results: Dietary assessment showed inadequate intakes of energy, protein, fat, calcium, zinc and folic acid. Intakes of vitamins A, C, D, B12, thiamine and riboflavin were particularly inadequate. Only carbohydrate, iron and niacin intakes reached fair levels of nutritional adequacy. Weak, non-significant correlations were observed between dietary nutrient intake and BMI, with vitamin C showing the strongest positive correlation (r = 0.164, p = 0.086). Nutritional status was significantly associated with age group, marital status, educational level and employment status (p < 0.05). Sex, religion, cigarette smoking, alcohol consumption, TB type and DOTS participation were not significantly associated with nutritional status.
Conclusion: Patients receiving anti-tuberculosis treatment had widespread inadequacies in macro- and micronutrient intake despite a mean BMI at the lower limit of the normal range. The results suggest that BMI alone may not provide an adequate measure of nutritional status. The results emphasise the need to improve nutritional care within tuberculosis programmes in Namibia. Anthropometric and dietary assessments should form part of routine nutritional review to identify macro- and micronutrient deficiencies early.
Keywords: Tuberculosis, nutritional status, dietary intake, body mass index, 24-hour dietary recall, micronutrients