Undernutrition and recovery in Pulmonary Tuberculosis: Insights from a study in Lucknow, India

<h2>Abstract:</h2><h3>Problem considered</h3> Undernutrition is a major risk factor for tuberculosis (TB), compromising immunity and adversely affecting treatment outcomes. India bears the highest global TB burden, with a large proportion of patients experiencing poor nutritional status. <h3>Methods</h3> A prospective observational study was conducted in 2022 among 272 adult pulmonary TB patients enrolled in six tuberculosis units of Lucknow district. Data were collected through a semi-structured questionnaire, anthropometric measurements, and 24-hour dietary recall. Nutritional status was assessed using body mass index (BMI), and dietary intake was analysed for adequacy of energy and protein. Treatment outcomes were obtained from programmatic records. <h3>Results</h3> The mean age of participants was 33±12 years, with males comprising 62.8%. At treatment initiation, 61% were undernourished (BMI <18.5), and only 32% attained normal weight by completion. The mean caloric intake was 1662.9 kcal, which was below recommended requirements, while protein intake was also insufficient. Although 99% were enrolled in Nikshay Poshan Yojana, only 4.7% reported receiving benefits. Dietary diversity was adequate in 66.9% of participants. Overall, 89.3% achieved successful treatment outcomes, but no statistically significant association was observed between BMI at treatment completion and outcome. <h3>Conclusion</h3> Undernutrition was highly prevalent among TB patients, with minimal nutritional recovery despite treatment. Suboptimal dietary intake and poor implementation of nutritional support schemes highlight the need for integrated interventions. Strengthening delivery of schemes like Nikshay Poshan Yojana and promoting dietary adequacy are critical to improving TB outcomes.