Undernutrition among Tuberculosis Patients in Southern Afghanistan: Prevalence and Determinants

BACKGROUND: Poor nutritional status among tuberculosis (TB) patients contributes to treatment failure and poor prognosis. However, no study has provided information on the nutritional conditions of Afghan TB patients. Using data from five TB care facilities in southern Afghanistan, this study aimed to determine the extent of undernutrition and examine its determinants in TB patients. METHODS: This was a cross-sectional study that utilised data from five TB care centres in four southern Afghan provinces. Data were collected between May and July 2025. Patients with TB who were aged ≥18 years were included in the analysis. Heights and weights were measured in metres (m) and kilograms (kg), respectively. Patients with a body mass index <18.5 kg/m2 were considered undernourished. Binary logistic regression was used to identify factors associated with undernutrition in TB patients. RESULTS: Of the 431 patients, 40.4% were undernourished. In adjusted models, odds of undernutrition were higher among females (adjusted odds ratio [AOR] 4.12; 95% confidence interval [CI] 2.41-7.04), rural residents (AOR 3.85; 95% CI 2.11-7.02), currently unmarried (AOR 1.86; 95% CI 1.11-3.13), smokers (AOR 11.06; 95% CI 5.27-23.21), patients with severe disease (AOR 2.23; 95% CI 1.16-4.28) and those with medical comorbidity (AOR 2.34; 95% CI 1.32-4.17). CONCLUSION: In conclusion, the prevalence of undernutrition is alarmingly high in Afghan TB patients. Therefore, nutrition-focused education and support should be considered key elements of TB care in Afghanistan.