Change in body weight and treatment outcome in sputum positive pulmonary tuberculosis patients treated under directly observed treatment short-course

Malangori A. Parande, Pradip S. Borle, Vinay S. Tapare, Sudhakar W. More, Susmita S. Bhattacharya


Background: Patients with tuberculosis often suffer from severe weight loss and is used as useful marker to predict TB treatment outcome. Hence a study was planned with an objective to determine the change of patient’s body weight over time throughout treatment and to determine whether there was any association with treatment outcome.

Methods: This was a retrospective cohort study, planned to be conducted among all smear positive pulmonary tuberculosis patients registered in a Tuberculosis Unit of Pune corporation, during the period of January to December 2015. Body weights of patients were recorded from TB treatment cards at the time of diagnosis, after 2 months of intensive phase of treatment and at the end of treatment. Total 344 cases were enrolled. Chi-Square test and Fisher’s exact test and repeated measure ANOVA test was used for analysis.

Results: A bad outcome was more likely among the category II cases as compared to category I, among non-adherent to treatment cases in continuation phase and higher sputum grading at the time of diagnosis i. e. in 3+ sputum smear grading. The weights of the patients at the time of diagnosis, at end of intensive phase and at end of treatment showed statistical significant difference (p<0.0001). The weight gain, more so at end of treatment was significantly associated with good outcome.

Conclusions: Weight gain has prognostic significance in patients with tuberculosis and should be considered as a surrogate marker to monitor response to TB treatment especially in developing countries where extensive laboratory tests are not feasible. 


Weight gain after treatment, Sputum smear grading, Tuberculosis, Adherence to treatment

Full Text:



WHO. Global Tuberculosis Report, 2016. Available at: Accessed on 8 March 2017.

Govt. of India. Nutritional care and support for patients with Tuberculosis in India, Central TB Division, Ministry of Health and Family Welfare, New Delhi. Available at: Accessed on 18 April 2017.

More SW, Parande MA, Kamble SW, Kamble MS. Profile of drug-resistant tuberculosis in Western Maharashtra. J Family Med Prim Care. 2017;6:29-33.

Bhargava A. Undernutrition, nutritionally acquired immunodeficiency, and tuberculosis control. BMJ. 2016: 355.

Padmapriyadarsini C, Shobana M, Lakshmi M, Beena T, Swaminathan S. Undernutrition & tuberculosis in India: Situation analysis & the way forward. Indian J Med Res. 2016;144(1):11-20.

Van Crevel R, Karyadi E, Netea MG, Verhoef H, Nelwan RH, West CE, et al. Decreased plasma leptin concentrations in Tuberculosis patients are associated with wasting and inflammation. J Clin Endocrinol Metab. 2002;87(2):758-63.

Vasantha M, Gopi PG, Subramani R. Weight gain in patients with tuberculosis treated under Directly Observed Treatment Short-Course (DOTS). Indian J Tuberculosis. 2009;56(1):5-9.

Kennedy N, Ramsay A, Uiso L, Gutmann J, Ngowi FI, Gillespie SH. Nutritional status and weight gain in patients with pulmonary tuberculosis in Tanzania. Trans R Soc Trop Med Hyg. 1996;90:162–6.

World Health Organization. Global tuberculosis control: surveillance, planning, financing. WHO report, 2009. Available at: Accessed on 30 March 2017.

Hoa NB, Lauritsen JM, Rieder HL. Changes in body weight and tuberculosis treatment outcome in Viet Nam. Int J Tuberc Lung Dis. 2012;17(1):61–6.

Revised National Tuberculosis Control Programme, 2005. Module for Laboratory Technicians. Central TB Division: Directorate General of Health Services, Ministry of Health and Family Welafre, New Delhi, India,22.

WHO, 2013:Definitions and Reporting framework for tuberculosis-2013 revision. Available at: Accessed on 22 January 2017.

WHO, 2015. Tuberculosis control in South East Asia region. Annual TB report 2015 Available at: Accessed on 18 July 2017.

Rohini K, Surekha Bhat, Srikumar PS, Jyoti Saxena, Mahesh Kumar A. Body Weight Gain in Pulmonary Tuberculosis during Chemotherapy. Int J Collaborative Res Internal Med Public Health. 2013;5(4):247-55.

Bernabe-Ortiz A, Carcamo CP, Sanchez JF, Rios J. Weight Variation over Time and Its Association with Tuberculosis Treatment Outcome: A Longitudinal Analysis. PLoS ONE. 2011;6(4):e18474.

Phan MN, Guy ES, Nickson RN, Kao CC. Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America. Int J Infect Dis. 2016;53:1–5.

Zachariah R, Spielmann MP, Harries AD, Salaniponi FM. Moderate to severe malnutrition in patients with tuberculosis is a risk factor associated with early death. Trans R Soc Trop Med Hyg. 2002;96:291–4.

Krapp F, Véliz JC, Cornejo E, Gotuzzo E, Seas C. Bodyweight gain to predict treatment outcome in patients with pulmonary tuberculosis in Peru. Int J Tuberc Lung Dis. 2008;12(10):1153-9.

How SH, Kuan YC, NG TH, Razali MR, Fuazi AR. Monitoring treatment response in sputum smear positive pulmonary tuberculosis patients: comparison of weight gain, sputum conversion and chest radiograph. Malaysian J Pathol. 2014;36(2):91-6.

Shelke SC, Adhav PS, Moonan PK, Willis M, Parande MA, Satyanarayana S, et al. Photovoice: A Novel Approach to Improving Antituberculosis Treatment Adherence in Pune, India. Hindawi Publishing Corporation Tuberculosis Res Treatment. 2014:302601:4.