Evidence map›Paper›PMID 33770535›Full record

ReviewThe Lancet. Infectious diseases2021

Food for thought: addressing undernutrition to end tuberculosis.

Pranay Sinha, Knut Lönnroth, Anurag Bhargava, Scott K Heysell, Sonali Sarkar, Padmini Salgame, William Rudgard, Delia Boccia, Daniel Van Aartsen, Natasha S Hochberg

Open access · greenAbstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review in The Lancet. Infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 68 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
68citing papers in PubMed, 2 pooled it
8.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

68 citing papers in PubMed, 2 syntheses or guidelines pooled it, 99 citations in OpenAlex.

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  19. Nutrition Supplement Improves Treatment Outcome among Adults on the Retreatment Regimen for Tuberculosis; A Two Arm Stepped Wedge Phased Implementation Study.Indian journal of community medicine : official publication of Indian Association of Preventive & Social Medicine · 2025
    Article
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8 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 8 institutions in 5 countries.

Pranay SinhaSection of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston University, MA, USA. Electronic address: sinha.pranay@pm.me.
Knut LönnrothDepartment of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
Anurag BhargavaDepartment of Medicine, Yenepoya Medical College, and Center for Nutrition Studies, Yenepoya (Deemed to be University), Mangalore, India; Department of Medicine, McGill University, Montreal, QC, Canada.
Scott K HeysellDivision of Infectious Diseases and International Health, University of Virginia, VA, USA.
Sonali SarkarDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Padmini SalgameCenter for Emerging Pathogens, Department of Medicine, Rutgers New Jersey Medical School, Newark, NJ, USA.
William RudgardDepartment of Social Policy and Intervention, University of Oxford, Oxford, UK.
Delia BocciaDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.
Daniel Van AartsenDivision of Infectious Diseases and International Health, University of Virginia, VA, USA.
Natasha S HochbergSection of Infectious Diseases, Department of Medicine, Boston University School of Medicine, Boston University, MA, USA; Department of Epidemiology, Boston University School of Public Health, Boston University, MA, USA.
Boston University · USUniversity of Virginia · USJawaharlal Institute of Post Graduate Medical Education and Research · INKarolinska Institutet · SELondon School of Hygiene & Tropical Medicine · GBRutgers, The State University of New Jersey · USUniversity of Oxford · GBYenepoya University · IN

Funding

INFECTIOUS DISEASES TRAINING PROGRAMT32AI007046 · NIAID · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI Alison K Criss, William A Petri · 1985 to 2026
$15.3M
Urine Colorimetry for Tuberculosis Pharmacokinetics Evaluation in Children and AdultsR01AI137080 · NIAID · UNIVERSITY OF VIRGINIA · PI Scott K Heysell, Leonid Kagan · 2018 to 2026
$6.3M
Global Biothreats Training ProgramT32AI055432 · NIAID · UNIVERSITY OF VIRGINIA CHARLOTTESVILLE · PI CRISS, ALISON K, PETRI, WILLIAM A · 2003 to 2022
$4.0M
Diagnostics and Pharmacotherapy for Severe Forms of TBU01AI115594 · NIAID · UNIVERSITY OF VIRGINIA · PI HEYSELL, SCOTT K, HOUPT, ERIC R · 2015 to 2019
$3.0M
NIAID NIH HHS R01 AI137080NIAID NIH HHS T32 AI007046NIAID NIH HHS T32 AI055432NIAID NIH HHS U01 AI115594
6 · The paper itself

Abstract

Tuberculosis is the leading cause of deaths from an infectious disease worldwide. WHO's End TB Strategy is falling short of several 2020 targets. Undernutrition is the leading population-level risk factor for tuberculosis. Studies have consistently found that undernutrition is associated with increased tuberculosis incidence, increased severity, worse treatment outcomes, and increased mortality. Modelling studies support implementing nutritional interventions for people living with tuberculosis and those at risk of tuberculosis disease to ensure the success of the End TB Strategy. In this Personal View, we highlight nutrition-related immunocompromisation, implications of undernutrition for tuberculosis treatment and prevention, the role of nutritional supplementation, pharmacokinetics and pharmacodynamics of antimycobacterial medications in undernourished people with tuberculosis, and the role of social protection interventions in addressing undernutrition as a tuberculosis risk factor. To catalyse action on this insufficiently addressed accelerant of the global tuberculosis epidemic, research should be prioritised to understand the immunological pathways that are impaired by nutrient deficiencies, develop tools to diagnose clinical and subclinical tuberculosis in people who are undernourished, and understand how nutritional status affects the efficacy of tuberculosis vaccine and therapy. Through primary research, modelling, and implementation research, policy change should also be accelerated, particularly in countries with a high burden of tuberculosis.

Indexed as

Antitubercular AgentsGlobal HealthHumansIncidenceMalnutritionNutritional StatusTuberculosisAntitubercular Agents

Identifiers

PMID33770535
PMCPMC8458477
OpenAlexW3138116310

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.