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

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.