Childhood tuberculosis and malnutrition

Abstract

Despite the burden of both malnutrition and tuberculosis in children worldwide, there are few studies on the mechanisms that underlie this relationship. From available research, it appears that malnutrition is a predictor of tuberculosis disease and is associated with worse outcomes. This is supported through several lines of evidence, including the role of vitamin D receptor genotypes, malnutrition's effects on immune development, respiratory infections among malnourished children, and limited work specifically on pediatric tuberculosis and malnutrition. Nutritional supplementation has yet to suggest significant benefits on the course of tuberculosis in children. There is a critical need for research on childhood tuberculosis, specifically on how nutritional status affects the risk and progression of tuberculosis and whether nutritional supplementation improves clinical outcomes or prevents disease.

Figure 1.

Role of genetics in tuberculosis susceptibility. The vitamin D receptor (VDR) has an integral role in the tuberculosis immune response through its binding with vitamin D to induce antimicrobial function via LL-37. Several polymorphisms in the VDR gene have also been implicated in tuberculosis susceptibility. Abbreviations: MTB, Mycobacterium tuberculosis; RXR, retinoid X receptor; TLR, Toll-like receptor; VD, vitamin D.