Alterações na composição corporal do indivíduo portador de tuberculose durante o tratamento: uma revisão da literatura

Abstract

Brazil remains among the thirty countries with a high burden of tuberculosis in the world and is therefore considered a priority for the control of the disease worldwide by the World Health Organization. In 2020, 66,819 new cases of tuberculosis were recorded, and in 2019, for and a half thousand deaths from the disease were reported, with a mortality coefficient of 2.2 deaths per a hundred thousand inhabitants. Tuberculosis is diagnosed by direct sputum smear microscopy (BAAR testing), which is currently the most widely used technique in Brazil, not only for diagnosis, but also for treatment control, using the Zeel-Neelsen methodology with the smear fixed on the slide and duly stained with fuchsin, cleaned with alcohol-acid, and then stained with methylene blue with a subsequent reading of one hundred fields. The basic tuberculosis treatment regimen recommended by the Ministry of Health consists of an attack or intensive phase and a maintenance phase lasting a total of six months. The attack phase lasts two months and uses four drugs (Rifampicin, Isoniazid, Pyrazinamide and Ethambutol or 2RHZE). The aim of these drugs is to rapidly reduce the bacillary population in order to contain infection as much as possible. Monitoring the patient's nutritional profile during anti-TB therapy prevents complications related to the infection, reducing the chances and length of hospitalization and additional costs for the health system. The relationship between tuberculosis and nutritional status is bidirectional, as the disease leads to a nutritional imbalance and this imbalance predisposes the patient to greater risks and aggravations of the disease. Objective: To identify the relationship between the body composition of individuals with tuberculosis during the treatment recommended by the Unified Health System. Methodology: For this study, an integrative literature review was carried out to verify the relationship between changes in the body composition of patients with tuberculosis during the treatment recommended by the Unified Health System. Results and discussion: fifteen publications were found on the subject of "Changes in the body composition of individuals with tuberculosis during treatment". Tuberculosis control involves a series of actions related to clinical practices, the organization of services, interactions with other areas within and outside the health sector and the information and surveillance system. Poor nutrition leads to energy-protein malnutrition and micronutrient deficiencies that lead to immunodeficiency. This secondary immunodeficiency increases the host's susceptibility to infection and thus increases the risk of developing tuberculosis. Tuberculosis itself leads to reduced appetite, malabsorption of nutrients and micronutrients, and altered metabolism leading to consumption and poor nutritional status.