Management of TB Patient - Severely Underweight

BMI level of less than 16 kg/m2 in men and less than 14 kg/m2 in women pose a threat to life, irrespective of other co-existing conditions. 
Assess

• Look for History of unintended weight loss, appetite, and oral intake, dietary assessment, vital signs, anemia, pedal edema, medical condition, socioeconomic condition, Family History.

   

Advise

• For Outpatient Care: If an assessment is met with normal clinical parameters.

• For Inpatient Care: If an assessment is met with high-risk clinical parameters where referral is required.

   

Manage

• Manage underlying active TB with effective treatment under close supervision and in consultation with Medical Officer DTC / DRTB Center.
• Access hydration & electrolytes (including potassium, magnesium). Prevent hypoglycemia, manage appropriately if present.
• Correct dehydration if present.
• Correct Vitamin and Minerals deficiencies with supplements as per clinical protocol.
• Do not expect weight gain in the first week, which is for the patient to stabilize. If required, initiate the slow calories intake accordingly.
• Increase feeding as appetite returns, aiming at weight gain from around 2 weeks.
• After successful discharge, follow up for 2 months.