Gupta Krishna Bihari, Gupta Rajesh, Atreja Atulya, Verma Manish, Vishvkarma Suman
Department of Tuberculosis and Respiratory Medicine, Pt. Bhagwat Dayal Sharma Post-Graduate Institute of Medical Sciences, Rohtak, India.
Lung India. 2009 Jan;26(1):9-16. doi: 10.4103/0970-2113.45198.
Malnutrition and tuberculosis are both problems of considerable magnitude in most of the underdeveloped regions of the world. These two problems tend to interact with each other. Tuberculosis mortality rates in different economic groups in a community tend to vary inversely with their economic levels. Similarly, nutritional status is significantly lower in patients with active tuberculosis compared with healthy controls. Malnutrition can lead to secondary immunodeficiency that increases the host's susceptibility to infection. In patients with tuberculosis, it leads to reduction in appetite, nutrient malabsorption, micronutrient malabsorption, and altered metabolism leading to wasting. Both, protein-energy malnutrition and micronutrients deficiencies increase the risk of tuberculosis. It has been found that malnourished tuberculosis patients have delayed recovery and higher mortality rates than well-nourished patients. Nutritional status of patients improves during tuberculosis chemotherapy. High prevalence of human immunodeficiency (HIV) infection in the underdeveloped countries further aggravates the problem of malnutrition and tuberculosis. Effect of malnutrition on childhood tuberculosis and tuberculin skin test are other important considerations. Nutritional supplementation may represent a novel approach for fast recovery in tuberculosis patients. In addition, raising nutritional status of population may prove to be an effective measure to control tuberculosis in underdeveloped areas of world.
在世界上大多数欠发达地区，营养不良和结核病都是相当严重的问题。这两个问题往往相互影响。社区中不同经济群体的结核病死亡率往往与其经济水平呈反比。同样，与健康对照组相比，活动性结核病患者的营养状况明显更低。营养不良会导致继发性免疫缺陷，增加宿主对感染的易感性。在结核病患者中，它会导致食欲下降、营养物质吸收不良、微量营养素吸收不良以及新陈代谢改变，进而导致消瘦。蛋白质 - 能量营养不良和微量营养素缺乏都会增加患结核病的风险。已发现营养不良的结核病患者比营养良好的患者康复延迟且死亡率更高。在结核病化疗期间患者的营养状况会有所改善。欠发达国家人类免疫缺陷病毒（HIV）感染的高流行率进一步加剧了营养不良和结核病问题。营养不良对儿童结核病和结核菌素皮肤试验的影响是其他重要的考虑因素。营养补充可能是结核病患者快速康复的一种新方法。此外，提高人群的营养状况可能被证明是控制世界欠发达地区结核病的有效措施。
