Handgrip strength deficit and time lag between symptom onset and starting of chemotherapy in pulmonary tuberculosis: A cross-sectional study in North India

Objectives: Wasting is the predominant systemic clinical manifestation of chronic diseases like tuberculosis (TB). Delay in diagnosis and therapy initiation may affect handgrip strength, severity and outcome of the disease. Limited data are available on this in the Indian context, despite a high prevalence of TB. This study aimed to estimate and correlate deficits in handgrip strength amongst sputum-positive and sputum-negative pulmonary TB patients in relation to the time lag between symptom onset and starting of antitubercular therapy (ATT). Materials and Methods: We conducted a cross-sectional study amongst newly diagnosed sputum-positive and sputum-negative pulmonary TB patients and age- and sex-matched apparently healthy volunteers. Handgrip strength of 341 newly diagnosed patients of TB was monitored within 1 week of starting ATT and analysed. Demographic details and clinical history of the participants were noted in the pre-designed form. The handgrip strength of 100 healthy volunteers was also taken for comparison. Results: The study findings suggest that deficits in handgrip strength amongst sputum-negative patients were more than sputum-positive patients in comparison to age- and sex-matched healthy controls. It took an average of 63 ± 27 days between the onset of symptoms and starting of ATT in sputum-negative patients in comparison to an average of 47 ± 12 days in sputum-positive patients. Conclusion: Early consultation by patients, rapid diagnosis of TB and the start of ATT, thereby decreasing the time lag between the symptom onset and start of ATT, may lead to a decreased deficit in handgrip strength with the improved overall health of patients. Extensive Information, Education and Communication activities and newer diagnostic modalities for early identification of cases and the start of chemotherapy are required for optimal management of TB patients.