The Effect of Body Mass Index (BMI) on the Treatment Outcomes of Drug Resistance Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis
Abstract
Background and Aim: Several host-related factors, such as nutritional status, age, and comorbid conditions, influence tuberculosis (TB) treatment outcomes by modifying disease progression and treatment response. However, their combined effect on TB outcomes has not been comprehensively evaluated. This study, therefore, aims to systematically assess the association between nutritional status, age, and HIV with TB treatment outcomes. Materials and Methods: We systematically searched cohort studies published between 2009 and 2025 in four databases using relevant keywords. After initial screening, eligible studies were included in the final analysis. Data were analyzed using Comprehensive Meta-Analysis (CMA) software with a random-effects model. Results: The overall favorable outcome for TB treatment was observed in 74.1% of cases (95% CI: 69.5–78.2), whereas unfavorable outcomes constituted 23.4% (95% CI: 19.8–27.4) of cases. Underweight patients, particularly those younger than 40.52 years, exhibited significantly reduced favorable outcomes (63.0%) and elevated mortality rates (16.6%). Investigations that excluded HIV-positive patients reported enhanced treatment success rates (77.7%) and diminished rates of both mortality (5.6%) and loss to follow-up (6.2%) in comparison to the general patient population. Conclusion: We found that in the studies with DR-TB patients with a mean BMI below 18.5 kg/m², a lower likelihood of treatment success compared to those with higher mean BMI…
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