Relationship Nutritional Status and Pulmonary Tuberculosis: Literature Review


  • Taufik Wijayanto Universitas Ahmad Dahlan
  • Solikhah Solikhah
  • Sulistyawati Sulistyawati Universitas Ahmad Dahlan



Nutritional Status, Risk Factor, Tuberculosis


Background: The incidence of tuberculosis is an important problem now. One of the risk factors that influence tuberculosis is nutritional status. Malnutrition and tuberculosis are interrelated problems.  Aims of the study is to clearly understand the relationship between nutritional status and the incidence of pulmonary tuberculosis literature. Method: A literature review was carried out by searching articles through electronic databases (Google Scholar, PubMed, ScienceDirect, and SpringerLink) using the keywords nutritional status, tuberculosis, risk factors for the incidence of tuberculosis, and nutritional status incidence of pulmonary tuberculosis. The inclusion criteria for the articles used were articles published in accredited National and International publications articles, year of publication of the articles in the range 2017-20123, full text, open access, and cross-sectional study research design. Seven articles were selected for analysis. Articles were analyzed following Prisma Guidelines. Results: Based on a literature review, it was found that there was a relationship between nutritional status and the incidence of pulmonary tuberculosis. Nutritional status affects a person’s immune system. When nutritional status is in poor condition, the body’s immune system will be low, making it susceptible to disease, one of which is pulmonary tuberculosis. On the other hand, tuberculosis can worsen a person’s nutrition due to the disease process. Conclusion: Based on studies, it is explained that nutritional status has a significant relationship and a high risk of the incidence of pulmonary tuberculosis. Nutritional status and pulmonary tuberculosis have a reciprocal relationship.

Author Biographies

Taufik Wijayanto, Universitas Ahmad Dahlan

Faculty of Public Health

Solikhah Solikhah

Fakultas Kesehatan Masyarakat, Universitas Ahmad Dahlan, Yogyakarta, Indonesia

Sulistyawati Sulistyawati, Universitas Ahmad Dahlan

Faculty of Public Health


Harding E. WHO global progress report on tuberculosis elimination. Lancet Respir Med. 2020 Jan;8(1):19. doi: 10.1016/S2213-2600(19)30418-7. Epub 2019 Nov 6. Erratum in: Lancet Respir Med. 2019 Nov 15;: PMID: 31706931.

Lestari T, Fuady A, Yani FF, Putra IWGAE, Pradipta IS, Chaidir L, Handayani D, Fitriangga A, Loprang MR, Pambudi I, Ruslami R, Probandari A. The development of the national tuberculosis research priority in Indonesia: A comprehensive mixed-method approach. PLoS One. 2023 Feb 9;18(2):e0281591. doi: 10.1371/journal.pone.0281591. PMID: 36758064; PMCID: PMC9910756.

Kasznia-Brown J. Global resources in the fight against tuberculosis. Pediatr Radiol. 2023 Aug;53(9):1746-1752. doi: 10.1007/s00247-023-05663-0. Epub 2023 May 9. PMID: 37160457; PMCID: PMC10169137.

Dwenger LV, Funke N, Stephany P, Suarez I, Wiesmüller GA, Neuhann F. Latente Tuberkulose unter Kontaktpersonen inzidenter Tuberkulosepatienten: Häufigkeit und Risikofaktoren in Köln 2012–2016 [Frequency Distribution and Risk Factors for Latent Tuberculosis in Contact Persons: Cologne 2012-2016]. Pneumologie. 2021 Aug;75(8):567-576. German. doi: 10.1055/a-1479-0168. Epub 2021 May 10. PMID: 33971674.

Sousa GJB, Monte GLA, Sousa DG, Maranhão TA, Pereira MLD. Spatiotemporal pattern of the incidence of tuberculosis and associated factors. Rev Bras Epidemiol. 2022 Apr 22;25:e220006. English, Portuguese. doi: 10.1590/1980-549720220006. PMID: 35475902.

Bhargava A, Bhargava M, Velayutham B, Thiruvengadam K, Watson B, Kulkarni B, Singh M, Dayal R, Pathak RR, Mitra A, Rade K, Sachdeva KS. The RATIONS (Reducing Activation of Tuberculosis by Improvement of Nutritional Status) study: a cluster randomised trial of nutritional support (food rations) to reduce TB incidence in household contacts of patients with microbiologically confirmed pulmonary tuberculosis in communities with a high prevalence of undernutrition, Jharkhand, India. BMJ Open. 2021 May 20;11(5):e047210. doi: 10.1136/bmjopen-2020-047210. PMID: 34016663; PMCID: PMC8141431..

Yang DL, Li W, Pan MH, Su HX, Li YN, Tang MY, Song XK. Spatial analysis and influencing factors of pulmonary tuberculosis among students in Nanning, during 2012-2018. PLoS One. 2022 May 24;17(5):e0268472. doi: 10.1371/journal.pone.0268472. PMID: 35609085; PMCID: PMC9129035.

Nguyen TH, Nguyen THN, Le Xuan H, Nguyen PT, Nguyen KC, Le Thi TN. Nutritional status and dietary intake before hospital admission of pulmonary tuberculosis patients. AIMS Public Health. 2023 May 23;10(2):443-455. doi: 10.3934/publichealth.2023031. PMID: 37304581; PMCID: PMC10251045.

Akkerman OW, Ter Beek L, Centis R, Maeurer M, Visca D, Muñoz-Torrico M, Tiberi S, Migliori GB. Rehabilitation, optimized nutritional care, and boosting host internal milieu to improve long-term treatment outcomes in tuberculosis patients. Int J Infect Dis. 2020 Mar;92S:S10-S14. doi: 10.1016/j.ijid.2020.01.029. Epub 2020 Jan 23. PMID: 31982628.

Park HY, Kang D, Shin SH, Choi H, Jang SH, Lee CH, Kim H, Kwon OJ, Rhee CK, Cho J. Pulmonary Tuberculosis and the Incidence of Lung Cancer among Patients with Chronic Obstructive Pulmonary Disease. Ann Am Thorac Soc. 2022 Apr;19(4):640-648. doi: 10.1513/AnnalsATS.202010-1240OC. PMID: 34478360.

Messias A, Pasquadibisceglie A, Alonso de Armiño D, De Simone G, Polticelli F, Coletta M, Ascenzi P, Estrin DA. Nitric oxide binding to ferrous nitrobindins: A computer simulation investigation. J Inorg Biochem. 2023 Nov;248:112336. doi: 10.1016/j.jinorgbio.2023.112336. Epub 2023 Aug 5. PMID: 37572543.

Tamara L, Kartasasmita CB, Alam A, Gurnida DA. Effects of Vitamin D supplementation on resolution of fever and cough in children with pulmonary tuberculosis: A randomized double-blind controlled trial in Indonesia. J Glob Health. 2022 Feb 18;12:04015. doi: 10.7189/jogh.12.04015. PMID: 35198149; PMCID: PMC8855907.

Wang JL, Zhou M, Zhang YA, Wang MS. Loculations and Associated Risk Factors of Childhood Pleural Tuberculosis. Front Pediatr. 2021 Dec 16;9:781042. doi: 10.3389/fped.2021.781042. PMID: 34976895; PMCID: PMC8716631.

Tucker E, Luscombe-Marsh N, Ambrosi C, Lushington K. Nutritional status and quality-of-life of older adults in aged care: A systematic review and meta-analysis. Exp Gerontol. 2022 Jun 1;162:111764. doi: 10.1016/j.exger.2022.111764. Epub 2022 Mar 7. PMID: 35271944.

Chhabra S, Kashyap A, Bhagat M, Mahajan R, Sethi S. Anemia and Nutritional Status in Tuberculosis Patients. Int J Appl Basic Med Res. 2021 Oct-Dec;11(4):226-230. doi: 10.4103/ijabmr.ijabmr_76_21. Epub 2021 Nov 17. PMID: 34912685; PMCID: PMC8633694.

Prieto-Huecas L, Piera-Jordán CÁ, Serrano De La Cruz-Delgado V, Zaragoza-Martí A, García-Velert MB, Tordera-Terrades C, Sánchez-Sansegundo M, Martín-Manchado L. Assessment of Nutritional Status and Its Influence on Ovarian Reserve: A Systematic Review. Nutrients. 2023 May 12;15(10):2280. doi: 10.3390/nu15102280. PMID: 37242163; PMCID: PMC10224518.

Jaganath D, Beaudry J, Salazar-Austin N. Tuberculosis in Children. Infect Dis Clin North Am. 2022 Mar;36(1):49-71. doi: 10.1016/j.idc.2021.11.008. PMID: 35168714; PMCID: PMC8867883.

Koegelenberg CFN, Schoch OD, Lange C. Tuberculosis: The Past, the Present and the Future. Respiration. 2021;100(7):553-556. doi: 10.1159/000516509. Epub 2021 May 25. PMID: 34034257.

Appiah PK, Osei B, Amu H. Factors associated with nutritional status, knowledge and attitudes among tuberculosis patients receiving treatment in Ghana: A cross-sectional study in the Tema Metropolis. PLoS One. 2021 Oct 14;16(10):e0258033. doi: 10.1371/journal.pone.0258033. PMID: 34648547; PMCID: PMC8516225.

Chen W, Ding Q, Zhang SK, Tong ZW, Ren F, Hu CM, Su SF, Kan XH, Cao H, Li R, Fang G, Guo XZ, Chen XH, Zhu GQ, Yao Q, Luo HY, Tang HM, Lin JY, Bertolaccini L, Fan L. Nutritional status in patients with active pulmonary tuberculosis and new nutritional risk screening model for active tuberculosis: a national, multicenter, cross-sectional study in China. J Thorac Dis. 2023 May 30;15(5):2779-2799. doi: 10.21037/jtd-23-623. Epub 2023 May 25. PMID: 37324100; PMCID: PMC10267931.

Wang X, Luo L, Zhang D, Wang J, Ning X, Lin Y, Ke X, Li G. Factors Associated with Nutritional Risk in Patients with Pulmonary Tuberculosis and Structural Lung Disease: A Hospital-Based Cross-Sectional Study. J Multidiscip Healthc. 2022 Aug 26;15:1799-1807. doi: 10.2147/JMDH.S375441. PMID: 36052303; PMCID: PMC9426578.

Jindal SK. Is pulmonary tuberculosis a true risk-factor for chronic obstructive pulmonary disease? Indian J Tuberc. 2022 Apr;69(2):131-133. doi: 10.1016/j.ijtb.2021.09.013. Epub 2021 Oct 4. PMID: 35379391.

Meitei HN, Pandey A, Haobam R. Polymorphisms in drug metabolism genes as a risk factor for first-line anti-tuberculosis drug-induced liver injury. Mol Biol Rep. 2023 Mar;50(3):2893-2900. doi: 10.1007/s11033-022-08158-7. Epub 2022 Dec 23. PMID: 36562936.

Hu M, Feng Y, Li T, Zhao Y, Wang J, Xu C, Chen W. Unbalanced Risk of Pulmonary Tuberculosis in China at the Subnational Scale: Spatiotemporal Analysis. JMIR Public Health Surveill. 2022 Jul 1;8(7):e36242. doi: 10.2196/36242. PMID: 35776442; PMCID: PMC9288096.

Chakaya J, Khan M, Ntoumi F, Aklillu E, Fatima R, Mwaba P, Kapata N, Mfinanga S, Hasnain SE, Katoto PDMC, Bulabula ANH, Sam-Agudu NA, Nachega JB, Tiberi S, McHugh TD, Abubakar I, Zumla A. Global Tuberculosis Report 2020 - Reflections on the Global TB burden, treatment and prevention efforts. Int J Infect Dis. 2021 Dec;113 Suppl 1(Suppl 1):S7-S12. doi: 10.1016/j.ijid.2021.02.107. Epub 2021 Mar 11. PMID: 33716195; PMCID: PMC8433257.

Chakaya J, Petersen E, Nantanda R, Mungai BN, Migliori GB, Amanullah F, Lungu P, Ntoumi F, Kumarasamy N, Maeurer M, Zumla A. The WHO Global Tuberculosis 2021 Report - not so good news and turning the tide back to End TB. Int J Infect Dis. 2022 Nov;124 Suppl 1:S26-S29. doi: 10.1016/j.ijid.2022.03.011. Epub 2022 Mar 20. PMID: 35321845; PMCID: PMC8934249.

Eto F, Nezu T, Aoki S, Kamimura T, Naito H, Shiga Y, Hosomi N, Maruyama H. The association between nutritional intake one week after admission and outcome in acute ischemic stroke patients. J Stroke Cerebrovasc Dis. 2022 Nov;31(11):106812. doi: 10.1016/j.jstrokecerebrovasdis.2022.106812. Epub 2022 Sep 29. PMID: 36183518

Prinja S, Sharma A, Nadipally S, Rana SK, Bahuguna P, Rao N, Chakraborty G, Shankar M, Rai V. Impact and cost-effectiveness evaluation of nutritional supplementation and complementary interventions for tuberculosis treatment outcomes under mukti pay-for-performance model in Madhya Pradesh, India: A study protocol. Int J Mycobacteriol. 2023 Jan-Mar;12(1):82-91. doi: 10.4103/2212-5531.307071. PMID: 36926768.

Zidni IN, Istiqomah ZS, Lina H. Nutritional Status of Children Under Five Years in the Work Area of Puskesmas Cipadung. Disease Prevention and Public Health Journal. 2021. Vol. 15, No. 2. doi:

Lisnaini, Weeke B, Meliana C. Nutritional Intake of Children in Kebon PalaEast Jakarta. Disease Prevention and Public Health Journal. 2023. Vol.17, No. 1. doi: