Abstract
BACKGROUND: This study assessed growth trajectories in children presenting with presumptive pulmonary TB (PTB). METHODS: This sub-study of the Umoya TB diagnostic study was conducted in South Africa from November 2017 until November 2021. Children (0-13 years) with presumptive PTB were recruited from and followed up for 12 months. Anthropometric measurements of children with TB, symptomatic controls (TB excluded), and healthy controls were taken at baseline and follow-up (2, 8, 16, 24 and 52 weeks). Changes in weight-for-age Z-score (WAZ), height-for-age Z-score (HAZ) and body mass index for age (BAZ) over time were assessed using multivariable mixed-effect linear regression adjusted for confounders. RESULTS: Of the 372 children included in the analyses (median age: 2 years, IQR 1-4), 153 children had TB, 168 were symptomatic and 51 were healthy controls. Median WAZ was similar between groups; however, more children with TB were underweight than symptomatic and healthy controls. WAZ increased over time for children with TB. Median HAZ of children with TB (-1.34, IQR -2.17 to -0.21) was lower compared to symptomatic (-1.06, IQR -1.90 to -0.10) and healthy controls (-0.74, IQR -1.26 to -0.03; P = 0.0037). There was no significant change over time for HAZ. CONCLUSION: To improve the long-term outcomes of TB and other illnesses, the overall nutrition of children needs to be improved.