Nutritional supplements for people being treated for active tuberculosis

A study was conducted to find the relationship between tuberculosis and malnutrition. It was stated that infection may lead to under nutrition due to high metabolic demand and decrease intake.

Search method was involved by reviewing central (The Cochrane Library), MEDLINE, EMBASE, LILACS, mRCT, and the Indian Journal of Tuberculosis to July 2011.

Randomized controlled trials (RCTs) studies were selected where oral nutritional supplement was given for  four weeks with no nutritional intervention, placebo, or dietary advice only to people being treated for active tuberculosis. Twenty-three trials with 6842 participants, were included.

Author concluded that there is insufficient research done to know whether routinely providing free food or energy supplements results in better tuberculosis treatment outcomes, or improved quality of life. Further trials with adequate sample sizes should be done to identify, or exclude, clinically important benefits.

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. . Tuberculosis commonly affects   the lungs, but can also affect other parts of the body. It   spreads from person to person through the air, when people who are infected with TB infection cough, sneeze or otherwise transmit respiratory fluids through the air. It is a disease   that can be cured with proper treatment. India has the highest TB burden according to World Health Organization (WHO) statistics for 2011, giving an estimated incidence of 2.2 million cases of TB  (India) out of a global incidence of 8.7 million cases.

Revised National Tuberculosis Control Programme (RNTCP)



Tuberculosis most commonly affects the lungs. Common symptoms of active lung TB   are:

  • A persistent cough of more than two weeks that brings up phlegm and blood at times
  • Breathlessness, which is usually mild to begin with and gradually gets worse
  • Lack of appetite and weight loss
  • A high temperature of 38ºC (100.4ºF) or above
  • Extreme tiredness or fatigue
  • Night sweats
  • Chest pains
  •  Less commonly TB infection  can   occure  in other organs of the body, as  :

Lymph nodes  , bones and joints, digestive system, nervous system, bladder and reproductive system. This is known as extra pulmonary TB. Symptoms of extra pulmonary TB vary according to organ/system affected. Extra pulmonary TB is more common in people with a weakened immune system, such as those with HIV.


The main cause of TB is Mycobacterium tuberculosis, a small, aerobics, non motile bacillus. TB spread when a person with an active TB infection in their lungs coughs or sneezes and someone else inhales the expelled droplets containing TB bacteria.

Risks factors: The most common risk factor associated with TB is HIV and other conditions that impair the immune system.

Other factors include:

  • Tobacco use
  • Malnutrition
  • Alcoholism


Symptomatic Diagnosis: Coughing for more than 2 weeks, loss of weight, loss of appetite, fever and night sweats, fatigue are common symptoms of tuberculosis. If someone has these symptoms, one should seek medical advice to check whether it is tuberculosis.

Blood tests

  • Sputum examination- Samples of mucous and phlegm are checked for the presence of bacteria.
  • Chest X-ray: This uses radiation to create an image of lungs. In TB infection, there are changes in the structure of lungs, which of lungs, are visible on the X-ray.
  • Drug susceptibility testing: It provides a definitive diagnosis of drug- resistant TB.

For TB of extra pulmonary sites. Diagnosis includes:

  • Computerized tomography (CT) scan: A series of X-rays of body is taken at slightly different angles and a computer puts the images together to create a detailed picture of the inside of body.
  • Magnetic resonance imaging (MRI) scan: A magnetic field and radio waves are used to produce detailed images of the inside of body.
  • Ultrasound scan: High-frequency sound waves create an image of part of the inside of the body.
  • Urine tests
  • Biopsy: A small tissue sample is taken from the affected site and tested for the presence of disease.


Tuberculosis is a treatable and curable disease. WHO-recommended Directly Observed Treatment, Short Course (DOTS) strategy was launched in Revised National Tuberculosis Control Programme (RNTCP) in India. Treatment for tuberculosis (TB) depends on which type of category (category I,II,III) patient is included  , although a long course of antibiotics are used.

In DOTS during the intensive phase of treatment a health care provider or health worker watches as the  patient swallow the medicine. During continuation phase, one week medicine in a multiblister combipack is issued to the patient. The consumption of medicine in continuation phase is also checked by health worker. It is recommended by the WHO in an effort to reduce the number of people not appropriately taking antibiotics. The recommended treatment of new-onset pulmonary tuberculosis, as of 2010, is six months of a combination of antibiotics containing rifampicin, isoniazid, pyrazinamide and ethambutol for the first two months and only rifampicin and isoniazid for the last four months. Where resistance to isoniazid is high, ethambutol may be added for the last four months as an alternative. If multiple drug-resistant TB (MDR-TB) is detected, treatment with at least four effective antibiotics for 18 to 24 months is recommended.


Prevention of TB is through vaccination. The only currently available vaccine as of 2011 is bacillus Calmette–Guérin (BCG), while it is effective against disseminated disease in childhood, confers inconsistent protection against contracting pulmonary TB.


  • LAST UPDATED ON : Jan 20, 2016


Write your comments

This question is for preventing automated spam submissions
The content on this page has been supervised by the Nodal Officer, Project Director and Assistant Director (Medical) of Centre for Health Informatics. Relevant references are cited on each page.