Undernutrition and Tuberculosis: Public Health Implications

Area of Science:

• Immunology
• Infectious Diseases
• Public Health

Background:

• Undernutrition affects nearly 800 million people globally, predominantly in low- and middle-income countries where tuberculosis (TB) is endemic.
• Undernutrition is a key driver of TB incidence, contributing significantly to the population attributable fraction of TB and leading to poorer treatment outcomes.
• Undernutrition impairs both innate and adaptive immune responses essential for controlling Mycobacterium tuberculosis infection and may impact live vaccine efficacy, such as BCG.

Purpose of the Study:

• To review the multifaceted effects of undernutrition on immune responses.
• To examine the impact of undernutrition on vaccine efficacy, TB incidence, disease severity, and treatment outcomes.
• To highlight the importance of addressing undernutrition within the World Health Organization's End TB strategy.

Main Methods:

• This study is a narrative review.
• It synthesizes existing data and literature on the relationship between undernutrition and tuberculosis.
• The review focuses on immunological, epidemiological, and clinical aspects.

Main Results:

• Undernutrition compromises the immune system's ability to fight Mycobacterium tuberculosis.
• Poor nutritional status is linked to increased TB incidence, greater disease severity, and reduced treatment success.
• There is evidence suggesting undernutrition may diminish the effectiveness of live vaccines like BCG.

Conclusions:

• Undernutrition significantly exacerbates tuberculosis globally.
• Integrating nutritional interventions into public health strategies is vital for TB control.
• Addressing undernutrition is a critical component of the World Health Organization's End TB strategy to improve outcomes and reduce disease burden.