Evidence map›Paper›PMID 40495301›Full record

ArticleThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2025

Impact of premorbid nutritional status on TB severity.

A Tabackman, A N Gupte, B Thangakunam, S P Babu, X Du, M Paradkar, S V B Y Shivakumar, S Gaikwad, K Ezhumalai, C Ponnuraja and 14 more

Abstract read
In one paragraph

Article in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
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

24 authors.

A TabackmanBoston Medical Center, Boston, MA, USA.
A N GupteDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.
B ThangakunamChristian Medical College, Vellore, India.
S P BabuDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
X DuDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.
M ParadkarByramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals-Johns Hopkins University Clinical Research Site, Pune, India;, Center for Infectious Diseases in India, Johns Hopkins India, Pune, India.
S V B Y ShivakumarCenter for Infectious Diseases in India, Johns Hopkins India, Pune, India.
S GaikwadByramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India.
K EzhumalaiDepartment of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
C PonnurajaIndian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai, India.
S CoxDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
N GupteByramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals-Johns Hopkins University Clinical Research Site, Pune, India;, Center for Infectious Diseases in India, Johns Hopkins India, Pune, India.
J A TornheimDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
M R DauphinaisBoston Medical Center, Boston, MA, USA.
A GuptaDivision of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
D J ChristopherChristian Medical College, Vellore, India.
H KornfeldDepartment of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA.
V MaveByramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals-Johns Hopkins University Clinical Research Site, Pune, India;, Center for Infectious Diseases in India, Johns Hopkins India, Pune, India.
V ViswanathanProf M Viswanathan Diabetes Research Centre, Chennai, India.
J J EllnerCenter for Emerging Pathogens, Department of Medicine, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ, USA.
L F WhiteDepartment of Biostatistics, Boston University School of Public Health, Boston, MA, USA.
C PadmapriyadarsiniIndian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai, India.
P SinhaBoston Medical Center, Boston, MA, USA;, Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
S SarkarDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.

Funding

Baseline pRescription According to Direct from Sputum Sequencing and TArgeted drug Concentration Strategy (BRASS TACS)R01AI168371 · NIAID · JOHNS HOPKINS UNIVERSITY · PI Jeffrey Tornheim · 2023 to 2026
$2.6M
Nutritional Interventions to End Tuberculosis among Persons with HIV (NUTRIENT)K01AI167733 · NIAID · BOSTON MEDICAL CENTER · PI Pranay Sinha · 2023 to 2026
$512k
NIAID NIH HHS K01 AI167733NIAID NIH HHS R01 AI168371
6 · The paper itself

Abstract

<sec><title>BACKGROUND</title>Undernutrition is the leading risk factor for TB worldwide and is associated with an increased risk of unfavorable outcomes and mortality. In this study, we assessed the impact of undernutrition before TB onset on radiographic and microbiological markers of TB severity.</sec><sec><title>METHODS</title>The RePORT India Consortium enrolled individuals with confirmed pulmonary TB (2015-2019). We used this data to conduct a prospective cohort analysis. Primary exposure was moderate-severe undernutrition (body mass index [BMI] <17 kg/m²) before TB disease was calculated using anthropometric data and patient-reported weight loss. Outcomes included lung cavitation, high-grade sputum smear positivity (>2+), percentage of lung affected, and time to positivity in mycobacterial growth indicator tube testing. We used multivariable regression and generalised additive models to assess non-linear relationships between premorbid undernutrition and outcomes.</sec><sec><title>RESULTS</title>Of 1,587 participants, 226 (14.2%) were undernourished before TB onset. Premorbid undernutrition was associated with increased odds of cavitation (aOR 1.80, 95% CI 1.14-2.89) and greater lung involvement (4.6%, 95% CI 0.73-8.42). The Generalized Additive Model (GAM) analysis revealed a non-linear relationship between premorbid BMI and cavitation but not for other severity metrics.</sec><sec><title>CONCLUSIONS</title>Premorbid undernutrition significantly increases the risk of severe pulmonary disease in TB patients. This underscores the importance of nutritional interventions to mitigate TB severity and improve outcomes.</sec>.

Indexed as

MalnutritionNutritional StatusTuberculosis, PulmonaryAdultBody Mass IndexFemaleHumansIndiaMaleMiddle AgedProspective StudiesRisk FactorsSeverity of Illness IndexSputumYoung Adult

Identifiers

PMID40495301
PMCPMC13271082

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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.