THE BODY WEIGHTS’ FOLLOW UP BEFORE AND AFTER THERAPY OF

ORAL ANTI-TUBERCULOSIS IN CHILDREN IN SURAKARTA FROM

JANUARY 2020 – DECEMBER 2022

Author

Department of Pediatric Health, Faculty of Medicine Sebelas Maret University-

Dr. Moewardi Hospital, Surakarta, Indonesia

ABSTRACT

Background
Tuberculosis remains an important children health problem, particularly in developing
countries. Weight is one of the symptoms of tuberculosis and is used in Indonesia to
determine the tuberculosis score in children. This study aims to get an overview of
body weight and body weight increment during oral anti-tuberculosis in Surakarta,
Jawa Tengah.
Material and methods
Medical records of children with tuberculosis in the Dr Moewardi Hospital of Central
Java located in Surakarta during January 2020 till December 2022 were compiled for
the children characteristic, body weight before and after oral anti-tuberculosis
treatment.
Result
There were 40 children medical records included in the study, children 0 to 12 years
old treated as tuberculosis. At the early treatment, some children were in severe
malnutrition (22.5%). However, after treatment of oral anti-tuberculosis, all of the
children (100%) got their body weight increment.
Conclusion
This study confirmed that body weight and weight gain remain important signs and
symptoms of tuberculosis before and after treatment. However, how much weight
plays a role in tuberculosis and other factors is not well understood.

Keywords: Body weight, Oral anti-tuberculosis, Increment, Children

Introduction pediatricians since its inception in 2008,
Mycobacterium tuberculosis is the leading particularly in resource-constrained settings.(3)
cause of death from a single bacterial
pathogen worldwide. The World Health International guidelines recommend monitoring
Organization (WHO) estimates that 1 weight as an indicator of therapeutic response in
million children are infected with TB each childhood tuberculosis (TB) disease. This study
year and many of them have latent aims to get an overview of body weight and
infections. However accurate assessments body weight increment during oral anti-
are hampered by lack of identification and tuberculosis in Surakarta, Jawa Tengah.
challenges in diagnosis; to date there is no
Material and Methods
accurate diagnostic test to confirm TB in
This is a hospital-based retrospective study in
children. Tuberculosis treatment takes a long
which the medical records of children (< 15
time but if started early the results are
years) diagnosed and treated for oral anti-
usually good. As we move towards an end-
tuberculosis between January 2020 and
to-end TB strategy better diagnosis and
December 2022 were selected and processed. Dr
treatment are needed to prevent unnecessary
Moewardi Hospital in Surakarta was selected
morbidity and mortality in children.(1)
purposively because it is a type A hospital,
which he owns provincial government and will
Tuberculosis remains a global health
serve as one of the referees hospitals for the
challenge, particularly among children.
district and other cities hospital in Central Java.
Indonesia is the second largest country (after
Listed in medical records tuberculosis and HIV,
India) suffering from tuberculosis in the
cancer, organ transplants, diabetes or chronic
world. In Indonesia, between 2013 and
diseases (heart and kidneys) excluded. Body
2017, children under 14 years of age with
weight in each medical record Observations on
tuberculosis ranged from 8 to 10.1 percent.
the beginning of tuberculosis treatment and
(2) Body weight (BW) is one of the
termination of 6-month therapy. and the
symptoms of tuberculosis and one of the
applicable curve (WHO or CDC) is thus applied
indicators used to indicate tuberculosis to
to body weight for age.
identify children with tuberculosis. The
tuberculosis score has been widely used by

2
Result
During the study period, there were 40
Table 3: Bodyweight per age of children at the early
children treated as tuberculosis; there are 40
stage of OAT treatment
medical records included in the study BW/Age N %
sample. There are 82.5% children age 1-5 Normal 26 65
years old, 10% age 6 – 10 years old and Mild 5 12.5

7.5% age 11 – 14 years old treated as Severe 9 22.5

Total 40 100
tuberculosis (Table 1).

Table 1: Characteristic of Respondent At the end of oral anti-tuberculosis therapy, all

Age N % of the children (100%) showed body weight
0 – 5 year old 33 82.5 increment. The body weight increment around
6 – 10 year old 4 10
0.5 - 5 kilogram (Table 4).
11 – 14 year old 3 7.5
Total 40 100
Table 4: BW comparison before and after OAT
therapy
Mainly the children treated as tuberculosis BW
N %
are male (57.5%) and 17 children are female Comparison

(42.5%) (Table 2). Similar 40 100

Increment 0 0
Lower 0 0
Table 2: Sex Distribution
Total 40 100
Sex N %
Male 23 57.5
Female 17 42.5 Discussion
Total 40 100 This study found that the age of children who got
tuberculosis was from 0 to 12 years old and
At the early of treatment started, many dominated by male. Children can present with
respondents suffer to malnutrition. There are tuberculosis disease at any age but most
9 children had severe malnutrition (22.5%), commonly, in tuberculosis-endemic countries,
5 children (12.5%) had mild malnutrition between 1-4 years. Pulmonary tuberculosis is the
and mostly had normal nutrition (65%) commonest type of TB in children.[4] In many
(Table 3). countries, older men are more likely to be
infected with tuberculosis (TB) than older

3
women. The study shows that boys are more decrease in the number of infections and the
likely to contract TB than girls, but the improvement in nutritional status due to the
results are too early to draw conclusions. treatment of tuberculosis.[8] Unfortunately, this
Until now, gender differences in TB have study was unable to provide an in-depth
contributed to delayed adulthood. [5] assessment of nutrition before and during disease
treatment.
Malnutrition and lung disease are two
closely related problems, especially in less
TB often leads to weight loss, affects the
developed regions of the world. The number
inflammatory response and suppresses cellular
of deaths due to tuberculosis is equal to the
immunity. Leptin is thought to mediate the
level of the economy. Similarly, the
complex relationship between TB, nutritional
nutritional status of patients with
status and immune response. Decreased body fat
tuberculosis is lower than that of healthy
mass is not the only cause of decreased plasma
controls.[6]
leptin concentration in TB patients. Although
body fat mass is the primary determinant of
Pulmonary TB as an infectious disease has a
plasma leptin concentrations, hunger, hormones
major influence on nutritional status due to
(such as insulin and cortisol), and various
decreased appetite, anorexia, and vomiting.
inflammatory mediators appear to modulate
It also causes long fever, which lead to an
leptin production. Research has shown that
increase in the nutritional needs of children.
lipopolysaccharides, TNF-α, and interleukin-1β
In addition, the treatment for pulmonary TB
can increase serum leptin concentration and
is a long process (6 months by minimum).
leptin mRNA in adipose tissue.[9]
During this period, a lack of intake in
pediatric pulmonary TB patients will affect
An increase in leptin levels in the body is related
their body weight and height.[7]
to an increase in energy, protein and fat intake,
which increases after the administration of oral
However, it is unclear how often nutritional
antituberculosis therapy, either in the intensive
children recover after TB treatment. The
phase or in the maintenance phase [3]. Thus,
study found that 100% respondents had
increased energy intake may increase body
gained weight by the end of TB treatment.
weight during and after tuberculosis treatment.
The increase is attributed to the rapid

4
In conclusion, this study confirmed that
body weight and weight gain remain
important signs and symptoms of
tuberculosis before and after treatment.
However, how much weight plays a role in
tuberculosis and other factors is not well
understood.

Acknowledgement
…

5
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