Magnitude of undernutrition and associated factors among patients with tuberculosis in the Benadir Region, Somalia: A multicenter cross-sectional study.

OBJECTIVES

Tuberculosis remains a major public health problem in low- and middle-income countries and is closely associated with poor nutritional status among patients. Undernutrition in patients with tuberculosis contributes to adverse treatment outcomes, increased morbidity, and delayed recovery. However, evidence on the magnitude of undernutrition and its associated factors among patients with tuberculosis in Somalia is limited. This study aimed to assess the prevalence of undernutrition and identify associated factors among adults with tuberculosis.

METHODS

An institution-based cross-sectional study was conducted among 362 patients with tuberculosis who attended selected tuberculosis treatment facilities. Data were collected using a structured questionnaire covering sociodemographic, household, dietary, clinical, and treatment-related factors. Anthropometric measurements were obtained using standardized procedures, and body mass index was calculated to assess nutritional status. Undernutrition was defined as a body mass index of <18.5 kg/m². Bivariate and multivariable logistic regression analyses were performed to identify factors associated with undernutrition, and adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were reported.

RESULTS

The prevalence of undernutrition among patients with tuberculosis was 37.6% (95% CI, 31.5-41.2). In the multivariable analysis, female sex (AOR = 3.93; 95% CI, 1.84-4.81), household size of 5 or more members (AOR = 3.15; 95% CI, 1.92-5.17), rural residence (AOR = 5.49; 95% CI, 3.16-9.28), extrapulmonary tuberculosis (AOR = 3.56; 95% CI, 1.93-6.27), continuation phase of treatment (AOR = 3.10; 95% CI, 1.92-4.11), treatment duration (AOR = 3.82; 95% CI, 2.09-5.30), and poor treatment adherence (AOR = 4.71; 95% CI, 2.81-8.02) were significantly associated with undernutrition.

CONCLUSION

Undernutrition was highly prevalent among adults with tuberculosis. Both sociodemographic and treatment-related factors were independently associated with undernutrition. These findings highlight the importance of integrating routine nutritional assessments and targeted nutritional support into tuberculosis care services.