{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T06:34:40Z","timestamp":1790922880361,"version":"4.1.0"},"reference-count":0,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["int j tuberc lung dis"],"published-print":{"date-parts":[[2025,5,30]]},"abstract":"<jats:p>&lt;sec&gt;&lt;title&gt;BACKGROUND&lt;\/title&gt;Undernutrition is the leading risk factor for TB worldwide and is associated with an increased risk of unfavorable outcomes and mortality. In this study, we assessed the impact of undernutrition before TB onset on radiographic and\n microbiological markers of TB severity.&lt;\/sec&gt;&lt;sec&gt;&lt;title&gt;METHODS&lt;\/title&gt;The RePORT India Consortium enrolled individuals with confirmed pulmonary TB (2015\u20132019). We used this data to conduct a prospective cohort analysis. Primary exposure was moderate-severe\n undernutrition (body mass index [BMI] &lt;17 kg\/m<jats:sup>2<\/jats:sup>) before TB disease was calculated using anthropometric data and patient-reported weight loss. Outcomes included lung cavitation, high-grade sputum smear positivity (&gt;2+), percentage of lung affected, and time to positivity in\n mycobacterial growth indicator tube testing. We used multivariable regression and generalised additive models to assess non-linear relationships between premorbid undernutrition and outcomes.&lt;\/sec&gt;&lt;sec&gt;&lt;title&gt;RESULTS&lt;\/title&gt;Of 1,587 participants, 226 (14.2%)\n were undernourished before TB onset. Premorbid undernutrition was associated with increased odds of cavitation (aOR 1.80, 95% CI 1.14\u20132.89) and greater lung involvement (4.6%, 95% CI 0.73\u20138.42). The Generalized Additive Model (GAM) analysis revealed a non-linear relationship between\n premorbid BMI and cavitation but not for other severity metrics.&lt;\/sec&gt;&lt;sec&gt;&lt;title&gt;CONCLUSIONS&lt;\/title&gt;Premorbid undernutrition significantly increases the risk of severe pulmonary disease in TB patients. This underscores the importance of nutritional interventions\n to mitigate TB severity and improve outcomes.&lt;\/sec&gt;<\/jats:p>","DOI":"10.5588\/ijtld.24.0592","type":"journal-article","created":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T04:30:46Z","timestamp":1749616246000},"page":"265-270","source":"Crossref","is-referenced-by-count":1,"title":["Impact of premorbid nutritional status on TB severity"],"prefix":"10.5588","volume":"29","author":[{"given":"A.","family":"Tabackman","sequence":"first","affiliation":[{"name":"Boston Medical Center, Boston, MA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.N.","family":"Gupte","sequence":"additional","affiliation":[{"name":"Department of Global Health, Boston University School of Public Health, Boston, MA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Thangakunam","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.P.","family":"Babu","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"X.","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Global Health, Boston University School of Public Health, Boston, MA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Paradkar","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals\u2013Johns Hopkins University Clinical Research Site, Pune, India;, Center for Infectious Diseases in India, Johns Hopkins India, Pune, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.V.B.Y.","family":"Shivakumar","sequence":"additional","affiliation":[{"name":"Center for Infectious Diseases in India, Johns Hopkins India, Pune, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Gaikwad","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals, Pune, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Ezhumalai","sequence":"additional","affiliation":[{"name":"Department of Preventive and Social Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Ponnuraja","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai, 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MA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Gupta","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, MD, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.J.","family":"Christopher","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Kornfeld","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Massachusetts Chan Medical School, Worcester, MA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Mave","sequence":"additional","affiliation":[{"name":"Byramjee Jeejeebhoy Government Medical College and Sassoon General Hospitals\u2013Johns Hopkins University Clinical Research Site, Pune, India;, Center for Infectious Diseases in India, Johns Hopkins India, Pune, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"V.","family":"Viswanathan","sequence":"additional","affiliation":[{"name":"Prof M Viswanathan Diabetes Research Centre, Chennai, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.J.","family":"Ellner","sequence":"additional","affiliation":[{"name":"Center for Emerging Pathogens, Department of Medicine, New Jersey Medical School, Rutgers Biomedical and Health Sciences, Newark, NJ, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.F.","family":"White","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"Padmapriyadarsini","sequence":"additional","affiliation":[{"name":"Indian Council of Medical Research, National Institute for Research in Tuberculosis, Chennai, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Sinha","sequence":"additional","affiliation":[{"name":"Boston Medical Center, Boston, MA, USA;, Section of Infectious Diseases, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Sarkar","sequence":"additional","affiliation":[{"name":"Department of Global Health, Boston University School of Public Health, Boston, MA, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3554","container-title":["The International Journal of Tuberculosis and Lung 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