Mohammad Reza Honarvar , Mahsa Ghaffari , Naser Behnampour ,
Volume 27, Issue 4 (12-2025)
Abstract
Background and Objective: Tuberculosis (TB), caused by a bacterium called Mycobacterium TB, is the most prevalent infectious disease leading to mortality worldwide. Weight loss is frequently observed in TB patients at the time of diagnosis. Body weight changes have been identified as a potential predictive marker for TB treatment outcomes, particularly in drug-susceptible cases. This study was conducted to evaluate weight changes during TB treatment and associated factors in Golestan Province, Iran.
Methods: This historical cohort study was conducted on 348 patients (178 males and 170 females) with TB referring to health centers in Golestan Province, Iran, in 2020. Data including age, gender, type of TB, pre- and post-treatment weight, place of residence (urban or rural), and treatment outcomes were extracted from patients’ medical records in the TB Register System. Weight changes were then compared before and after treatment across three groups: Smear-positive pulmonary TB, smear-negative pulmonary TB, and extra-pulmonary TB.
Results: Patients’ post-treatment weight showed a statistically significant mean increase of 1.98 kg (P<0.05). Based on the grade of sputum smear positivity, post-treatment weight gain was higher in pulmonary TB patients (both smear-positive and smear-negative) compared to extra-pulmonary cases. Overall, weight gain in all three groups (smear-positive pulmonary TB, smear-negative pulmonary TB, and extra-pulmonary TB) was statistically significant (P<0.05). Furthermore, weight gain was significant across all groups of sputum smear positivity (+ to +++) (P<0.05), with the most substantial weight changes occurring in patients with a ++ sputum smear. Mean weight gain was also significant in both smear-negative patients and other categories (P<0.05), with smear-negative individuals showing higher weight gain than other states. Although weight gain was slightly higher in men than in women, it was statistically significant in both genders (P<0.05). Weight gain was significant in both urban and rural residents (P<0.05), with rural patients exhibiting more pronounced weight gain. Significant weight gain was observed across individuals under 15, 15–65, and over 65 years of age (P<0.05). The least weight changes were observed in the over 65 age group, while the most significant changes occurred in those under 15.
Conclusion: The type of TB (pulmonary versus extra-pulmonary), the grade of sputum smear positivity, treatment outcomes, gender, place of residence, and age were identified as factors associated with weight changes in patients with TB.
