Body mass index and albumin levels of drug-resistant tuberculosis patients: a retrospective cohort study

Abstract Background Drug-resistant TB (DR-TB) remains a global health challenge due to its prolonged treatment and negative impact on quality of life. Poor nutritional status is associated with increased risk and poor treatment outcomes. This study aims to determine BMI and serum albumin levels in patients with DR-TB in Dr. Hasan Sadikin Bandung Hospital, a tertiary referral hospital in West Java, Indonesia at the time of DR-TB diagnosis and end of treatment completion. Methods Adult pulmonary DR-TB patients with GeneXpert and phenotypic DST-confirmed drug resistance were enrolled in at Dr. Hasan Sadikin Bandung General Hospital. Data were retrospectively collected from medical records of those treated at the DR-TB clinic between 2021 and 2023. Demographics, BMI, and serum albumin levels were documented at both treatment initiation and upon successful or completed treatment. Results Overall, BMI significantly improved after treatment compared with baseline ( p < 0.0001). Although half of the participants had low BMI at baseline, 73 (44.5%) achieved normal BMI by the end of treatment. Meanwhile, 54 (32.9%) remained underweight, and overweight/obesity increased from 25 (15.2%) to 37 (22.6%).Similarly, serum albumin levels significantly improved after treatment ( p < 0.0001). Hypoalbuminemia was seen in 54 (32.9%) participants at baseline, but only 4 (2.4%) after treatment. Conclusions This study revealed that a considerable number of DR-TB patients who completed treatment successfully still experiences malnutrition, and that BMI and serum albumin do not always recover in parallel. These findings underscore the importance of routine nutritional assessment and support in DR-TB management to enhance immunological recovery and long-term health outcomes.