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Tuberculosis outcomes in Papua, Indonesia: The relationship with different Body Mass Index characteristics between Papuan and Non-Papuan ethnic groups

Kenangalem, Enny, Waramori, Govert, Pontororing, Gysje J., Sandjaja, Tjitra, Emiliana, Maguire, Graeme, Kelly, Paul M., Anstey, Nicholas M. and Ralph, Anna P. (2013). Tuberculosis outcomes in Papua, Indonesia: The relationship with different Body Mass Index characteristics between Papuan and Non-Papuan ethnic groups. PLoS One,8(9):e76077-1-e76077-9.

Document type: Journal Article
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IRMA ID cmartelxPUB91
NHMRC Grant No. 605806
496600
Title Tuberculosis outcomes in Papua, Indonesia: The relationship with different Body Mass Index characteristics between Papuan and Non-Papuan ethnic groups
Author Kenangalem, Enny
Waramori, Govert
Pontororing, Gysje J.
Sandjaja
Tjitra, Emiliana
Maguire, Graeme
Kelly, Paul M.
Anstey, Nicholas M.
Ralph, Anna P.
Journal Name PLoS One
Publication Date 2013
Volume Number 8
Issue Number 9
ISSN 1932-6203   (check CDU catalogue  open catalogue search in new window)
Scopus ID 2-s2.0-84884685150
Start Page e76077-1
End Page e76077-9
Total Pages 9
Place of Publication United States of America
Publisher Public Library of Science
HERDC Category C1 - Journal Article (DIISR)
Abstract Weight gain achieved during pulmonary tuberculosis (PTB) treatment is associated with the likelihood of bacteriological treatment success. It is recognised that weight and body mass index (BMI) characteristics differ between ethnic groups in health and illness states. However there has been no prior investigation of how ethnic differences in BMI might influence tuberculosis treatment outcome. Our aim was to investigate predictors of microbiological response to PTB treatment at the Tuberculosis Clinic in Timika, Papua Province, Indonesia and specifically, to determine the contribution of ethnicity. The population comprises two distinct ethnic groups - Asian (Non-Papuan) and Melanesian (Papuan). We conducted a prospective study of adults with smear-positive PTB. Treatment outcomes were 1- and 2-month sputum culture and time to microscopy conversion. Clinical measures included weight, BMI, chest radiograph, pulmonary function including forced expiratory volume in 1 second (FEV1) and haemoglobin. One hundred eighty six participants (83 Papuan, 103 non-Papuan Indonesians) were enrolled. At baseline, Papuans had higher mean weight and BMI than non-Papuans (50.0 kg versus 46.9 kg, p = 0.006 and 20.0 kg/m2 versus 18.7 kg/m2, p = 0.001 respectively). This was despite having lower mean haemoglobin (11.3 vs 13.1 g/dL, p<0.0001), higher smoking and HIV rates (37% vs 21%, p = 0.02 and 20% vs 5%, p = 0.01 respectively) and longer median illness duration (3 vs 2 months, p = 0.04), but similar radiological severity (proportion with cavities 55% vs 57%, p = 0.7), sputum smear grade (p = 0.3) and mean % predicted FEV1 (63% vs 64%, p = 0.7). By 2 months, Papuans had gained still more weight (mean 5.9 vs 4.2 kg, p = 0.02), and were more likely to have negative sputum culture (49/56 vs 45/67, p = 0.02), in univariable and multivariable analyses controlling for other likely determinants of culture conversion. In conclusion, Papuans had better early microbiological outcome from PTB treatment, which may relate to better preservation of weight and greater early weight gain.

DOI http://dx.doi.org/10.1371/journal.pone.0076077   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)
Additional Notes This is an Open Access article distributed under the terms of the Creative Commons Attribution License 4.0, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Description for Link Link to CC Attribution 4.0 License
URL https://creativecommons.org/licenses/by/4.0/au/legalcode


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