Nutritional support effect on the nutritional status and tolerability of chemotherapy in children in the real clinical practice of the tuberculosis dispensary

Abstract

S.F. Barbolina1,2, A.G. Naumov1,2, O.A. Ovchinnikova3, R.R. Bikbaev3 1Privolzhsky Research Medical University, Nizhny Novgorod, Russian Federation 2Nizhny Novgorod Regional Clinical Tuberculosis Dispensary, Nizhny Novgorod, Russian Federation 3Regional Clinical Tuberculosis Dispensary, Astrakhan, Russian Federation Aim: in conditions of the real clinical practise, to evaluate the effect of nutritional support (NS) with a hypercaloric polymer formula with dietary fibers on the nutritional status of children with pulmonary tuberculosis (TB) who started chemotherapy, as well as the possible NS impact on the chemotherapy efficacy and tolerability. Patients and Methods: a retrospective and prospective, partial cross-sectional cohort study was conducted. The main group (prospective) included 23 children with an established diagnosis of pulmonary TB and I–III degree underweight. In the comparison group (retrospective), 20 children were selected who corresponded to the main characteristics of the main group patients. Main group, in addition to a balanced individually selected hospital diet, received NS with a hypercaloric polymer formula with dietary fibers in the amount of 100 ml 2 times a day on a daily basis (300 kcal/day). The patient's body weight, height, subscapular skinfold thickness, body mass index (BMI) Z-score, hemoglobin level, total protein, urine specific gravity, chemotherapy tolerance and NS product tolerance (in the main group) were assessed initially and after 3 months. Results: the study demonstrated that the NS use has a significant positive effect on the nutritional status (body weight, height, BMI) of children with malnutrition who received chemotherapy in pulmonary TB. NS use with a specialized product contributed to a significant improvement in blood parameters (an increase in hemoglobin and total protein count) and normalization of urine specific density versus the comparison group, which achieved no significant improvement in these indicators. The good tolerability of the specialized product helped to reduce the risk of adverse events during daily chemotherapy administration by 65.2%, which improved treatment adherence. Conclusion: the obtained results confirmed the NS administration efficacy for children with diagnosed pulmonary TB during chemotherapy indicated to normalize the nutritional status. Keywords: tuberculosis, children, adverse events, nutritional support, adherence, efficacy. For citation: Barbolina S.F., Naumov A.G., Ovchinnikova O.A., Bikbaev R.R. Nutritional support effect on the nutritional status and tolerability of chemotherapy in children in the real clinical practice of the tuberculosis dispensary. Russian Journal of Woman and Child Health. 2023;6(4):405–410 (in Russ.). DOI: 10.32364/2618-8430-2023-6-4-13.