(EA03-02-25) A Roadmap for Integrating Nutritional Assessment, Counselling, and Support Into the Care of People With Tuberculosis

Scientific conference where the work was recently presented: 9th Africa Nutrition Conference (ANC2024) / ANEC IX in October 2024 (Cape Coast, Ghana)

Pranay also presented parts of this work at the Union World Conference on Lung Health 2024, in November 2024 (Bali).

Date on which the work was previously presented at the scientific conference listed: October 2024 & November 2024

Objectives: Undernutrition—the leading risk factor for tuberculosis worldwide—is associated with impaired immunity, more extensive disease, delayed sputum conversion, and worse treatment outcomes, including mortality. We propose a comprehensive roadmap for integrating nutritional assessment, counselling, and support into tuberculosis treatment as part of person-centered care. At treatment initiation, we recommend nutritional assessment with anthropometric measurements and hemoglobin estimation, in addition to macronutrient and micronutrient support alongside nutritional counselling. Weight should be monitored during treatment and lack of weight gain at the end of intensive phase should prompt an investigation of causes, such as food insecurity, poor treatment adherence, malabsorption, uncontrolled diabetes, or drug resistance. At the end of treatment, we recommend reassessing anthropometric measures to assess nutritional recovery. People with tuberculosis who remain underweight should receive close follow-up to detect early relapse. We call for annual reporting of nutritional metrics by WHO, explicit inclusion of nutritional assessment and care in national strategic plans, domestic or international support of nutritional programmes for people with tuberculosis, increased support for operational research initiatives, and integration of nutritional care into the WHO Multisectoral Accountability Framework at national and regional levels.

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Funding Sources: PS (NIH K01AI167733-01A1), Burroughs Wellcome/American Society of Tropical Medicine & Hygiene Postdoctoral fellowship, CRDF Global (DAA3-19-65673-1), Warren Alpert Foundation (6005415). JPC: NIH/National Institute of Allergy and Infectious Diseases (K24AI114444), and Emory/Georgia TB Research Advancement Center (P30AI168386). SKH: NIH and Fogarty International Center grant (D43TW012247).