e-Library of Evidence for Nutrition Actions (eLENA)

Management of severe acute malnutrition 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. Young children and pregnant women are particularly vulnerable to the effects of undernutrition and TB. Women with TB may be at higher risk for pre-eclampsia and other complications during pregnancy. TB also increases the risk of premature birth, low birth weight and perinatal death.

Severe acute malnutrition is identified differently in different age groups:

  • Children under 5 years of age: very low weight-for-height/weight-for-length, or clinical signs of bilateral pitting oedema, or very low mid-upper arm circumference (children 6-59 months of age only)
  • School-age children and adolescents 5-19 years of age: very low BMI*-for-age
  • Adults: very low BMI
  • Pregnant women: very low mid-upper arm circumference

Those suffering from severe acute malnutrition are particularly susceptible to the negative health effects of tuberculosis.

WHO recommendations

School-age children and adolescents (5 to 19 years), and adults, including pregnant and lactating women, with active TB and severe acute malnutrition should be treated in accordance with the WHO recommendations for management of severe acute malnutrition (IAMI manual, Technical note; see 'WHO documents' below).

Children who are less than 5 years of age with active TB and severe acute malnutrition should be treated in accordance with the WHO recommendations for the management of severe acute malnutrition in children who are less than 5 years of age (updated guideline on management of SAM; see 'WHO documents' below).

* BMI = body mass index, kg/m2


This is a summary of WHO recommendations on the management of severe acute malnutrition in individuals with active tuberculosis. The full set of recommendations can be found in the guideline, Nutritional care and support for patients with tuberculosis , under ‘WHO documents’ below.

WHO documents


GRC-approved guidelines
Other guidance documents

Evidence


Systematic reviews used to develop the guidelines
Clinical trials
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Last update:

28 July 2014 17:22 CEST

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Category 1 intervention

Guidelines have been recently approved by the WHO Guidelines Review Committee