Accès ouvert déclaré 2026 article

Association of undernutrition and tuberculosis outcomes: a retrospective multicentre cohort study in Italy

Francesco Di Gennaro, Giacomo Guido, Gina Gualano, Alessandro Cornelli, Rosa Buonamassa, Francesco Cavallin, Mariantonietta Pisaturo, Lorenzo Onorato, Federica Zimmerhofer, Giuseppe Brunò, Massimo Fasano, Agostina Pontarelli, Tiziana Iacovazzi, Luisa Frallonardo, Gianfranco Panico, Raffaella Libertone, Caterina Monari, Alessia Musto, Francesca Serapide, Mariangela Niglio, Luca Pipitò, Sergio Cotugno, Roberta Papagni, Alberto Enrico Maraolo, Stefania Stolfa, Loredana Alessio, Giulio Viceconte, Giuseppina De Iaco, R Lattanzio, Federica De Gregorio, Aurelia Ricciardi, Paola Mencarini, Helen Linda Morrone, Ylenia Farinaccio, Gaetano Brindicci, Carmen Pellegrino, Marinella Cibelli, Giorgia Manco Cesari, Vito Spada, Paolo Tundo, Carmen Rita Santoro, Giuliana Metrangolo, Anna Maria Maci, Grazia Pietramatera, Salvatore Minniti, Caterina Sagnelli, Giovanni Battista Buccoliero, Sergio Lo Caputo, Alessandra Prozzo, Sergio Carbonara, Antonio Cascio, Ivan Gentile, Alessandro Russo, Roberto Parrella, Fabrizio Palmieri, N Coppola, Annalisa Saracino

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19Institutions déclarées

2Pays d’affiliation déclarés

Rattachement africain : it, es. Niveau de preuve : code pays fourni par la source.

Le résumé fourni par la source

Objectives Undernutrition remains one of the most powerful yet neglected determinants of tuberculosis (TB) incidence and progression. While its impact on TB outcomes has been extensively described in low-income countries, limited evidence is available from high-income settings. This study aimed to assess the association between BMI strata at treatment initiation and TB-related outcomes in a large multicenter cohort from Italy. Methods We conducted a retrospective, multicenter observational study including all adults diagnosed with TB between January 2021 and August 2025 in 16 Infectious and Tropical Diseases Units across seven Italian regions. Patients were stratified by body mass index (BMI) at treatment initiation (<16, 16–16.99, 17–18.49, 18.5–24.99, and ≥25 kg/m 2 ). Outcomes included time to sputum conversion, length of hospital stay, occurrence and severity of adverse events (AEs), incomplete treatment (including failure, death, and loss to follow-up), and loss to follow-up (LTFU). Multilevel regression models adjusting for study center and relevant confounders were used to assess associations between BMI strata and each outcome. Results A total of 709 people with TB were included (median age, 38 years [IQR 28–53]; 488/709, 75.5% male). Overall, 299/709 (42%) were underweight (BMI <18.5 kg/m 2 ). Compared with people with TB with normal BMI (18.5–24.99 kg/m 2 ) , those with severe undernutrition (BMI <16 kg/m 2 ) showed higher rates of adverse events (54/74 [73.0%] vs 101/410 [24.6%]; adjusted odds ratio [aOR] 12.17, 95% CI 6.41–23.08), incomplete treatment (53/74 [71.6%] vs 87/410 [21.2%]; aOR 18.28, 95% CI 6.70–49.80), and loss to follow-up (41/74 [55.4%] vs 81/410 [19.7%]; aOR 5.99, 95% CI 2.58–13.90). Median hospital stay was also longer in this group (50 days [IQR 24–66] vs 30 days [IQR 18–60]), corresponding to a 23% adjusted increase. Weight gain during the first six months of treatment was not significantly associated with major outcomes. Conclusions Severe underweight at treatment initiation is a major independent predictor of poor outcomes in TB. These findings highlight the need for systematic nutritional assessment and targeted interventions within TB programs, even in high-income, low-incidence settings.

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Le contrôle bibliographique ouvert

DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.

Titre Crossref: Association of undernutrition and tuberculosis outcomes: a retrospective multicentre cohort study in Italy
Date Crossref: 01/07/2026
Éditeur: Elsevier BV
Type: journal-article

Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.

Où se fait cette recherche

University of Bari Aldo Moro Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ) pays non établi dans la notice
Université ou école supérieure
Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani pays non établi dans la notice
Établissement de santé
University of Campania "Luigi Vanvitelli" pays non établi dans la notice
Université ou école supérieure
University of Pavia Department of Internal Medicine and Medical Therapy pays non établi dans la notice
Université ou école supérieure
Istituto Nazionale di Statistica pays non établi dans la notice
Structure de recherche
Department of Health pays non établi dans la notice
Organisme public
University of Palermo Department of Health Promotion pays non établi dans la notice
Université ou école supérieure
Azienda Ospedaliera S.Giuseppe Moscati pays non établi dans la notice
Établissement de santé
Ospedale D. Cotugno pays non établi dans la notice
Établissement de santé
Ospedale degli Infermi pays non établi dans la notice
Établissement de santé
Ospedale A. Perrino pays non établi dans la notice
Établissement de santé
Magna Graecia University Department of Medical and Surgical Sciences pays non établi dans la notice
Université ou école supérieure

Department of Precision and Regenerative Medicine and Jonian Area (DiMePreJ) — University of Bari Aldo Moro, Istituto Nazionale per le Malattie Infettive Lazzaro Spallanzani et University of Campania "Luigi Vanvitelli", avec 9 autres affiliations.

Une affiliation ne permet pas de déduire la nationalité d’un auteur.

Les sujets associés

Tuberculosis Research and EpidemiologyDiagnosis and treatment of tuberculosisChild Nutrition and Water Access

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