Undernutrition and Tuberculosis: Public Health Implications

Pranay Sinha, Juliana Davis, Lauren Saag, Christine Wanke, Padmini Salgame, Jackson Mesick, C. Robert Horsburgh, Natasha S. Hochberg

Research output: Contribution to journalReview articlepeer-review

47 Scopus citations


Almost 800 million people are chronically undernourished worldwide, of whom 98% are in low- and middle-income countries where tuberculosis is endemic. In many tuberculosis-endemic countries, undernutrition is a driver of tuberculosis incidence and associated with a high population attributable fraction of tuberculosis and poor treatment outcomes. Data suggest that undernutrition impairs innate and adaptive immune responses needed to control Mycobacterium tuberculosis infection and may affect responses to live vaccines, such as BCG. Given its impact on tuberculosis, addressing undernutrition will be a vital component of the World Health Organization End TB strategy. This narrative review describes the effect of undernutrition on the immune response, vaccine response, and tuberculosis incidence, severity, and treatment outcomes.

Original languageEnglish (US)
Article numberjiy675
Pages (from-to)1356-1363
Number of pages8
JournalJournal of Infectious Diseases
Issue number9
StatePublished - Apr 16 2019

All Science Journal Classification (ASJC) codes

  • Immunology and Allergy
  • Infectious Diseases


  • Undernutrition
  • body mass index
  • latent Mycobacterium tuberculosis infection
  • nutrition disorders
  • tuberculosis


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