Food for thought: addressing undernutrition to end tuberculosis.
Journal
The Lancet. Infectious diseases
ISSN: 1474-4457
Titre abrégé: Lancet Infect Dis
Pays: United States
ID NLM: 101130150
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
30
01
2020
revised:
18
07
2020
accepted:
04
09
2020
pubmed:
27
3
2021
medline:
17
11
2021
entrez:
26
3
2021
Statut:
ppublish
Résumé
Tuberculosis is the leading cause of deaths from an infectious disease worldwide. WHO's End TB Strategy is falling short of several 2020 targets. Undernutrition is the leading population-level risk factor for tuberculosis. Studies have consistently found that undernutrition is associated with increased tuberculosis incidence, increased severity, worse treatment outcomes, and increased mortality. Modelling studies support implementing nutritional interventions for people living with tuberculosis and those at risk of tuberculosis disease to ensure the success of the End TB Strategy. In this Personal View, we highlight nutrition-related immunocompromisation, implications of undernutrition for tuberculosis treatment and prevention, the role of nutritional supplementation, pharmacokinetics and pharmacodynamics of antimycobacterial medications in undernourished people with tuberculosis, and the role of social protection interventions in addressing undernutrition as a tuberculosis risk factor. To catalyse action on this insufficiently addressed accelerant of the global tuberculosis epidemic, research should be prioritised to understand the immunological pathways that are impaired by nutrient deficiencies, develop tools to diagnose clinical and subclinical tuberculosis in people who are undernourished, and understand how nutritional status affects the efficacy of tuberculosis vaccine and therapy. Through primary research, modelling, and implementation research, policy change should also be accelerated, particularly in countries with a high burden of tuberculosis.
Identifiants
pubmed: 33770535
pii: S1473-3099(20)30792-1
doi: 10.1016/S1473-3099(20)30792-1
pmc: PMC8458477
mid: NIHMS1731813
pii:
doi:
Substances chimiques
Antitubercular Agents
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e318-e325Subventions
Organisme : NIAID NIH HHS
ID : R01 AI137080
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI007046
Pays : United States
Organisme : NIAID NIH HHS
ID : T32 AI055432
Pays : United States
Organisme : NIAID NIH HHS
ID : U01 AI115594
Pays : United States
Informations de copyright
Copyright © 2021 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of interests We declare no competing interests
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