Effectiveness of nutritional support to improve treatment adherence in patients with tuberculosis: a systematic review

Fasil Wagnew; Darren Gray; Tsheten Tsheten; Matthew Kelly; Archie C A Clements; Kefyalew Addis Alene

doi:10.1093/nutrit/nuad120

Effectiveness of nutritional support to improve treatment adherence in patients with tuberculosis: a systematic review

Nutr Rev. 2023 Sep 27:nuad120. doi: 10.1093/nutrit/nuad120. Online ahead of print.

Authors

Fasil Wagnew^{1

2}, Darren Gray³, Tsheten Tsheten¹, Matthew Kelly¹, Archie C A Clements⁴, Kefyalew Addis Alene^{5

6}

Affiliations

¹ National Centre for Epidemiology and Population Health, College of Health and Medicine, The Australian National University, Canberra, Australian Capital Territory, Australia.
² College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia.
³ Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
⁴ Penninsula Medical School, University of Plymouth, Plymouth, United Kingdom.
⁵ Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Nedlands, Western Australia, Australia.
⁶ Faculty of Health Sciences, School of Population Health, Curtin University, Bentley, Western Australia, Australia.

PMID: 37759339
DOI: 10.1093/nutrit/nuad120

Abstract

Context: Nutritional interventions substantially improve tuberculosis (TB) treatment outcomes and prevent complications. However, there is limited evidence about the connections between having nutritional support and TB treatment adherence.

Objective: The aim of this study was to determine the effectiveness of nutritional support in improving treatment adherence among patients with TB.

Data sources: Databases, including PubMed, Embase (Ovid), Web of Science, and Scopus, were comprehensively reviewed to identify relevant studies reporting the impacts of nutritional support on TB treatment adherence.

Data extraction: Two authors independently screened the title, abstracts, and full article texts to identify eligible studies and assess the risk of bias. Observational and interventional studies were included.

Data analysis: A narrative synthesis approach was used to summarize the findings qualitatively.

Results: From the search, 3059 publications were identified; of these, 8 studies were included in this systematic review. Three types of nutritional interventions were identified: food baskets (eg, energy, micronutrient- or macronutrient-enriched food support), nutritional advice and guidance, and incentives for buying foods. Although 5 studies reported that nutritional support significantly improved treatment adherence in patients with TB, 3 studies showed that nutritional support had no effect on TB treatment adherence.

Conclusions: Providing nutritional support may improve adherence to TB treatment. However, more well-powered, high-quality trials are warranted to demonstrate the effect of nutrition support on cost-effectively improving adherence to TB treatment.

Systematic review registration: PROSPERO registration no. CRD42023392162.

Keywords: TB; nutritional support; systematic review; treatment adherence.