Nutritional care and support for patients with tuberculosis

Overview

This guideline provides guidance on the principles and evidence-informed recommendations on the nutritional care and support for patients with tuberculosis.

Undernutrition increases the risk of tuberculosis and in turn tuberculosis can lead to malnutrition. Undernutrition is therefore highly prevalent among people with tuberculosis. It has been demonstrated that undernutrition is a risk factor for progression from tuberculosis infection to active tuberculosis disease and that undernutrition at the time of diagnosis of active tuberculosis is a predictor of increased risk of death and tuberculosis relapse. However, the evidence concerning the effect of nutritional supplementation on tuberculosis prevention and health outcomes among people with tuberculosis had not previously been systematically reviewed.

Member States have requested guidance from the World Health Organization (WHO) on nutritional care and support for patients with tuberculosis.

Evidence

The primary audience for the guideline is health workers providing care to people with tuberculosis. However, the guideline is also intended for a wider audience including policy-makers, their expert advisers, and technical and programme staff at organizations involved in the design, implementation and scaling-up of nutrition actions for public health.

• Sinclair D, Abba K, Grobler L, Sudarsanam TD.
  Nutritional supplements for people being treated for active tuberculosis. Cochrane Database Syst. Rev. 2011;(11):CD006086. DOI: 10.1002/14651858.CD006086.pub3.
• Lönnroth K, Williams BG, Cegielski P, Dye C.
  A consistent log-linear relationship between tuberculosis incidence and body mass index. Int. J. Epidemiol. (2010) 39 (1): 149-155 first published online October 9, 2009 doi:10.1093/ije/dyp308
• Hood MLH.
  A narrative review of recent progress in understanding the relationship between tuberculosis and protein energy malnutrition. European Journal of Clinical Nutrition (2013) 67, 1122–1128; doi:10.1038/ejcn.2013.143; published online 14 August 2013. (pdf, 497kb)

Additional links and resources

• Meeting report. Geneva, 2–4 November 2009
  Scoping meeting for the development of guidelines on nutritional/food support to prevent TB and improve health status among TB patients. Geneva: World Health Organization; 2010.
• Other WHO publications on tuberculosis

1. Executive summary