Abstract
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Introduction: Tuberculosis (TB) remains a major global public health problem. Undernutrition is one of the most potent risk factors for TB. Low circulating concentrations of micronutrients such as vitamin B12, vitamin D3, and minerals including iron, zinc, and selenium have biological plausibility in the development and progression of active TB.
Materials and Methods: A community-based cross-sectional study was conducted among 160 newly diagnosed adult pulmonary TB patients from June to November 2024. After obtaining informed consent, participants were randomly recruited. Blood samples were collected to assess nutritional biomarkers. Relevant socio-demographic and dietary information was obtained using a pre-designed, pre-tested questionnaire.
Results: Among the 160 study participants, the mean age was 38.01 ± 15.69 years. Most belonged to the upper-lower socioeconomic class (65%), and 21.9% were educated up to middle school. Poor household ventilation was observed in 28.8% of participants, while overcrowding was present in 39.4% of households. Dietary counselling had been provided to 59.4% of participants; however, only 20.6% reported adherence. Calorie and protein deficiencies were observed in 88.8% and 79.4% of participants, respectively, with mean deficits of 444.73 ± 572.98 kcal and 26.94 ± 36 g. Overall, 60% of participants were undernourished, of whom 11.3% were severely malnourished. Micronutrient deficiencies included vitamin D3 deficiency (83.4%), anemia (80.6%), low cholesterol levels (50.6%), vitamin B12 deficiency (20.6%), low serum iron (14.4%), and low serum ferritin (22.5%). Combined micronutrient deficiencies were present in 10% of participants. Low levels of vitamin D, serum iron, and serum ferritin were significantly more common among undernourished TB patients compared to those with normal nutritional status.
Conclusion: A high proportion of newly diagnosed pulmonary TB patients were undernourished, with significant calorie and protein gaps in their recommended daily intake. These dietary deficiencies were strongly associated with multiple micronutrient deficiencies. Incorporation of identified nutrients through locally available foods may improve nutritional status and contribute to better treatment outcomes in TB patients.
Keywords: Undernutrition, Pulmonary TB, Micronutrient, Dietary Gaps, Proten Deficiency
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