Implementation of BMI field charts for nutritional assessment in adult patients with tuberculosis in Karnataka

BACKGROUND We tested the operational feasibility of body mass index (BMI) field charts in nutritional assessment of adult patients with tuberculosis (PwTB), which obviate calculations and provide nutritional status based on BMI and the ideal weight (BMI = 21 kg/m 2 ). METHODS We trained primary health care providers (HCPs) in 39 primary health centres for nutritional assessment and classification and identifying the ideal weight using BMI field charts in PwTB. Using the descriptive statistics method, we analysed the collected data and reported the nutritional status in PwTB and the uptake of the field charts among the HCPs. RESULTS The median (interquartile range [IQR]) weight and BMI were 44 kg (37.0, 50.0) and 16.9 kg/m 2 (15.2, 18.9), respectively, in 214 PwTB, of which 146 (68.2%) patients had a BMI of <18.5 kg/m 2 . The HCPs documented the ideal weight in 155 (72.4%) patients, which was correct in 147 (94.8%) patients. The median (IQR) weight deficit to achieve the ideal weight was 10.4 kg (7.3, 12.8) in men and 11.9 kg (7.0, 17.9) in women. For a BMI of 18.5 kg/m 2 , the deficit was 6.4 kg (3.4, 8.5) in men and 11.3 kg (4.6, 13.6) in women. CONCLUSION The magnitude and severity of undernutrition in adult PwTB in a well-performing district of Karnataka in South India were high. A single training session successfully improved nutritional assessment and BMI field chart usage among the primary HCPs.