WHO consolidated guidelines on tuberculosis: module 6: tuberculosis and comorbidities: web annex D: systematic review results and unpublished data presented at the guideline development group meeting on tuberculosis and undernutrition, 2024

This web annex presents systematic review findings and unpublished data considered by the WHO guideline development group for the second edition of Module 6 of the WHO consolidated guidelines on tuberculosis, focusing on tuberculosis and undernutrition. The document summarizes evidence on nutritional interventions and micronutrient supplementation for people with tuberculosis receiving treatment, as well as interventions for household contacts, acceptability and feasibility considerations, and cost-effectiveness analyses. It describes review questions, study characteristics, risk-of-bias assessments and quantitative syntheses of evidence from randomized and non-randomized studies conducted in diverse settings.

The annex reports the effects of dietary support, micronutrient supplementation, counselling, food vouchers, cash transfers and other nutritional interventions on tuberculosis treatment outcomes, nutritional status and physical wellbeing. Findings suggest that some interventions, including energy–protein supplementation, food vouchers and counselling with or without financial support, may improve selected treatment and nutritional outcomes, although certainty of evidence varied across comparisons. The document also identifies important evidence gaps, including limited reporting on adverse events, survival, patient costs and pregnancy outcomes. The annex was developed to support transparency in WHO guideline development and to inform recommendations on nutritional support for people affected by tuberculosis.