The relationship between malnutrition and tuberculosis
Cegielski, J.P. and McMurray, D.N., 2004. The relationship between malnutrition and tuberculosis: evidence from studies in humans and experimental animals. The international journal of tuberculosis and lung disease, 8(3), pp.286-298.
Malnutrition increases the risk of tuberculosis (TB) due to weakened cell-mediated immunity (CMI). Malnourished individuals are more likely to progress from primary or latent TB infection to active disease. Poverty links poor nutrition and higher TB risk, with malnutrition and TB rates rising together in such populations. Case Study 1: Denmark during WWI Case Study 2: Trondheim, Norway Naval Training School Case Study 3: WWII British and Russian POWs Understanding the timing between malnutrition and TB onset is crucial to assess cause-effect relationships. TB itself can cause malnutrition-like symptoms, complicating cause-effect analysis in studies. Low intake of fruits, vegetables, and vitamin C may lead to higher hospitalization rates rather than higher TB rates. Vitamin supplementation has been shown to reduce the risk of TB among family contacts of active TB cases.
- Denmark exported most protein-rich foods during the war, causing a rise in TB rates.
- After a German blockade in 1918, local food availability improved, and TB rates dropped.
- TB rates continued to rise in neighboring warring countries without improved nutrition.
- High TB rates due to crowded and unhygienic conditions.
- TB rates did not decline with better housing and hygiene.
- TB morbidity dropped after diet was fortified with nutritious foods.
- Both groups had the same prison diet, but British prisoners received additional Red Cross food supplements.
- British prisoners had significantly lower TB rates (1.2%) compared to Russian prisoners (15-19%).
- Better nutrition correlated with higher plasma proteins and lower TB severity in British prisoners.
- Malnourished prisoners had rapid onset and severe TB, indicating poor CMI.
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