Turkiye Klinikleri Journal of Medical Sciences

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Nutritional Burden in Tuberculosis and Inter-sectoral Nutritional Management for Tuberculosis Patients in Malaysia
Malezya'da Tüberkülozda Beslenme Yükü ve Sektörler Arası Beslenme Yönetimi: Malezya'da Bir Gözden Geçirme
Khalid MOKTIa, Zaleha ISAb, Mohd Rizal ABDUL MANAFb, Firdaus HAYATIc, Syed Sharizman SYED ABD RAHIMa
aMalaysia Sabah University Faculty of Medicine and Health Sciences, Department of Community and Family Medicine, Kota Kinabalu, MALAYSIA
bKebangsaan Malaysia University Faculty of Medicine, Department of Community Health, Kuala Lumpur, MALAYSIA
cMalaysia Sabah University Faculty of Medicine and Health Sciences, Department of Surgery, Kota Kinabalu, MALAYSIA
Turkiye Klinikleri J Med Sci. 2020;40(1):83-95
doi: 10.5336/medsci.2019-70810
Article Language: EN
Full Text
ABSTRACT
Undernutrition and tuberculosis (TB) are a vital issue in most developing countries of the world. Both of these medical problems tend to have interacted with each other and bidirectional. The undernutrition creates a more significant problem in patients with active TB rather than among healthy individuals. Despite that, there is no protocol available on nutritional support in Malaysia to tackle on this issue. The objective of this review is to explore the nutrition burden of TB disease and the management available in Malaysia. The treatment for TB lasts for six months and above. Hence, it causes a financial burden not only for the healthcare provider but for the patient and the family members. If treatment is not successful and extends to a few months, it will increase the cost of the treatment. Malnutrition in TB patients will cause a problem in the outcome of TB treatment. It includes worsening of the disease, delayed sputum conversion, and increased risk of mortality. Other problems include malabsorption of Rifampicin, drug-induced hepatotoxicity, increased rate of relapse, and persistent of positive cultures in MDR-TB. Benefits of nutritional support for tuberculosis patients include improved body weight, increase in adherence/ compliance to the tuberculosis treatment and increase in the success of the treatment. Implementation of nutritional support protocol by the government and Non-profit organization (NGO) will be beneficial and improve the quality of life of tuberculosis patients.

Keywords: Malnutrition; nutritional status; tuberculosis; Malaysia
ÖZET
Beslenme yetersizliği ve tüberküloz (TB) dünyanın gelişmekte olan birçok ülkesinde hayati bir konudur. Bu tıbbi sorunların her ikisi de birbirleriyle etkileşime girme ve çift yönlü olma eğilimindedir. Beslenme yetersizliği, sağlıklı bireylerden ziyade aktif TB'li hastalarda daha önemli bir problem yaratır. Buna rağmen, Malezya'da bu konuda mücadele edecek beslenme desteği konusunda protokol bulunmamaktadır. Bu derlemenin amacı TB hastalığının beslenme yükünü ve Malezya'da bulunan yönetimi araştırmaktır. TB tedavisi altı ay ve daha uzun sürer. Dolayısıyla, sadece sağlık hizmeti sağlayıcısı için değil, hasta ve aile üyeleri için finansal bir yüke neden olmaktadır. Eğer tedavi başarılı olmaz ve birkaç aya kadar uzarsa, tedavinin maliyetini yükseltir. TB hastalarındaki yetersiz beslenme, TB tedavisinin sonucunda bir soruna neden olacaktır. Hastalığın kötüleşmesini, balgam dönüşümünü geciktirmeyi ve ölüm riskini arttırmayı içerir. Diğer problemler arasında Rifampisin salgılanması, ilaca bağlı hepatotoksisite, artmış nüks oranı ve MDR-TB'de pozitif kültürlerin kalıcılığı bulunur. Tüberküloz hastaları için beslenme desteğinin faydaları arasında vücut ağırlığının iyileştirilmesi, tüberküloz tedavisine uyumun artması ve tedavinin başarısının artması yer alır. Devlet ve sivil toplum kuruluşları (STK) tarafından beslenme destek protokolünün uygulanması yararlı olacak ve tüberküloz hastalarının yaşam kalitesini artıracaktır.

Anahtar Kelimeler: Kötü beslenme; beslenme durumu; tüberküloz; Malezya
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