ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2023
Impact of Undernutrition on Tuberculosis Treatment Outcomes in India: A Multicenter, Prospective, Cohort Analysis.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 2 of them syntheses that pooled it.
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Who cites it
61 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Barriers to engagement in the care cascade for tuberculosis disease in India: A systematic review of quantitative studies.PLoS medicine · 2024Pooled it
- Prevalence and risk factors of malnutrition in patients with pulmonary tuberculosis: a systematic review and meta-analysis.Frontiers in medicine · 2023Pooled it
- Energy dense nutritional supplements improve weight gain among malnourished adults with drug-sensitive pulmonary tuberculosis: An open-label randomized controlled trial in Faridabad, India.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2026Trial
- Host and pathogen factors modulate tuberculosis clinical severity independent of molecular bacterial burden: insights from a multicenter Ghanaian cohort.IJID regions · 2026Article
- Post-tuberculosis lung disease in treated extra-pulmonary tuberculosis.American journal of respiratory and critical care medicine · 2026Article
- Addressing inequities in nutritional supplementation in tuberculosis: implementation research from Puducherry, India.Public health action · 2026Article
- Impact of undernutrition and diabetes on the pharmacokinetics of first-line anti-TB drugs.IJTLD open · 2026Article
- Tuberculosis and Cellular Metabolism: Insights into the Crosstalk Between Macrophage Immunometabolism and Muscle Dysregulation.International journal of molecular sciences · 2026Review
- Clinical and imaging factors associated with paraplegia at presentation in thoracic spinal tuberculosis.International orthopaedics · 2026Article
- Mid-upper arm circumference predicts treatment outcomes in paediatric TB: a cohort study.IJTLD open · 2026Article
- Clinical and transcriptomic risk factors for post-tuberculosis lung disease in a cohort of Kenyan adults.American journal of respiratory and critical care medicine · 2026Observational
- A Narrative Review of the Regional Prospective Observational Research in Tuberculosis International Consortium: Sharing Diverse Data and Specimens in the Fight Against Tuberculosis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Review
- Impact of comorbid diseases and associated factors on tuberculosis treatment outcomes among tuberculosis patients in South West Oromia, Ethiopia: a retrospective cohort study.Scientific reports · 2026Article
- Infection with Mycobacterium tuberculosis depletes host fatty acids in humans and non-human primates.EBioMedicine · 2026Article
- Assessing mortality risk in pulmonary tuberculosis and severe malnutrition: development of the IIR marker via artificial intelligence.Scientific reports · 2026Article
- In-kind Nutritional Supplementation for Persons With Drug-susceptible Tuberculosis and Their Household Contacts Would be Cost-effective for Reducing Tuberculosis Incidence and Mortality in Jharkhand, India: A Modeling Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Article
- Diagnosis and treatment of severe tuberculosis complicated by ARDS and MODS in a young immunosuppressed host: a case report.Frontiers in medicine · 2026Article
- Combination interventions to control the tuberculosis epidemic in the Karamoja subregion of Uganda: A modelling analysis.PLOS global public health · 2026Article
- Tuberculosis- learning about experience with nutritional supplementation (TB LENS): Perspectives on a nutritional supplementation for persons with TB and their household contacts.Global public health · 2025Article
1 more citing papers are in PubMed but not listed here.
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27 authors.
Funding
Abstract
backgroundUndernutrition is the leading risk factor for tuberculosis (TB) globally. Its impact on treatment outcomes is poorly defined.
methodsWe conducted a prospective cohort analysis of adults with drug-sensitive pulmonary TB at 5 sites from 2015-2019. Using multivariable Poisson regression, we assessed associations between unfavorable outcomes and nutritional status based on body mass index (BMI) nutritional status at treatment initiation, BMI prior to TB disease, stunting, and stagnant or declining BMI after 2 months of TB treatment. Unfavorable outcome was defined as a composite of treatment failure, death, or relapse within 6 months of treatment completion.
resultsSevere undernutrition (BMI <16 kg/m2) at treatment initiation and severe undernutrition before the onset of TB disease were both associated with unfavorable outcomes (adjusted incidence rate ratio [aIRR], 2.05; 95% confidence interval [CI], 1.42-2.91 and aIRR, 2.20; 95% CI, 1.16-3.94, respectively). Additionally, lack of BMI increase after treatment initiation was associated with increased unfavorable outcomes (aIRR, 1.81; 95% CI, 1.27-2.61). Severe stunting (height-for-age z score <-3) was associated with unfavorable outcomes (aIRR, 1.52; 95% CI, 1.00-2.24). Severe undernutrition at treatment initiation and lack of BMI increase during treatment were associated with a 4- and 5-fold higher rate of death, respectively.
conclusionsPremorbid undernutrition, undernutrition at treatment initiation, lack of BMI increase after intensive therapy, and severe stunting are associated with unfavorable TB treatment outcomes. These data highlight the need to address this widely prevalent TB comorbidity. Nutritional assessment should be integrated into standard TB care.
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