e-Library of Evidence for Nutrition Actions (eLENA)

Nutrition assessment and counselling in individuals with active tuberculosis

In 2012 there were an estimated 8.6 million new cases of tuberculosis (TB) globally. TB morbidity and mortality are highest in developing countries.

Undernutrition increases the risk of tuberculosis and vice-versa and, as a result, undernutrition is highly prevalent among people with tuberculosis. It has been demonstrated that undernutrition is a risk factor for progression from tuberculosis infection to active tuberculosis disease and that undernutrition at the time of diagnosis of active tuberculosis is a predictor of increased risk of death and tuberculosis relapse. However, the evidence concerning the effect of nutritional supplementation on tuberculosis prevention and health outcomes among people with tuberculosis had not previously been systematically reviewed.

Nutrition assessment and counselling are critical components of managing undernutrition in individuals with active tuberculosis.

WHO recommendations

All individuals with active TB should receive: i) an assessment of their nutritional status, and ii) appropriate counselling based on their nutritional status at diagnosis and throughout treatment.


This is one of several WHO recommendations on nutritional care of individuals with TB. The full set of recommendations can be found in 'Full set of recommendations' and in the guidelines, under ‘WHO documents’ below.

WHO documents

WHO documents

GRC-approved guidelines


Systematic reviews used to develop the guidelines
Related Cochrane reviews
Clinical trials