Nutritional status and associated factors among adult patients with tuberculosis in public hospitals of Sidama Region, Ethiopia

In Ethiopia, while undernutrition among adult patients with tuberculosis (PWTB) is well-documented, evidence on anemia and its coexistence with undernutrition remains limited. This study was aimed at assessing nutritional status and associated factors among adult PWTB attending public hospitals of Sidama Region. A facility-based cross-sectional study was conducted from 4 February to 27 March 2024 among 418 systematically sampled PWTB from public hospitals. Data were collected using pretested structured questionnaires and analyzed in STATA 14. Modified Poisson regression with robust standard errors identified factors associated with nutritional status, presented as adjusted prevalence ratios (APR) with 95% confidence intervals (CI). The magnitudes of undernutrition and anemia were 37.1% (95% CI: 32.4-41.7) and 48.6% (95% CI: 43.7-53.4) respectively. Intestinal parasites were detected in 25.1% (95% CI: 20.9-29.3) of adult PWTB. Anemia prevalence was significantly higher in undernourished PWTB (87.1%) compared to those with normal nutrition (25.8%; p < 0.001). Undernutrition was associated with food-insecurity (APR = 1.89; 95% CI: 1.47-2.45), low dietary diversity (APR = 1.56; 95% CI: 1.21-2.01), TB-HIV coinfection (APR = 1.65; 95% CI: 1.23-2.21), and parasite infection (APR = 1.78; 95% CI: 1.41-2.25). The identified predictors of anemia among PWTB were food insecurity (APR = 1.41; 95% CI: 1.16-1.73), parasitic infection (APR = 1.23; 95% CI: 1.01-1.51), and TB-HIV coinfected (APR = 1.36; 95% CI: 1.04-1.77). The study revealed a prevalence of undernutrition and anemia among PWTB, with key predictors including poor dietary diversity, food insecurity, TB-HIV coinfection, and parasitic infection. Given the public health significance of anemia, especially among undernourished patients, we recommend integrating routine nutritional screening and targeted interventions-such as food support, parasite control, and HIV care-into TB treatment programs.