Summary
Prithi (name changed to protect privacy) lay restless on the floor of her dwelling in a northern Indian village feeling like she was being devoured from the inside. The gnawing hunger that had plagued her life as a girl aged 15 years was now accompanied by nightly fever. The knobs of her spine clearly visible through her threadbare tunic, she coughed relentlessly. She had no energy for domestic chores—her responsibility since her mother died of tuberculosis in 2024.
Tuberculosis is preventable and curable, yet stories like Prithi’s are common. 10 million people become sick and 1·2 million individuals die from tuberculosis each year.1 Although Mycobacterium tuberculosismight ultimately be the pathogen that kills them, undernutrition remains a pervasive contributing cause. An estimated 673 million people experienced hunger and undernutrition in 2024.2 The links between infectious diseases, such as tuberculosis, and undernutrition are likely due to the complex interplay between nutritional status and immune system function.3 Undernutrition is present in almost half of people diagnosed with tuberculosis,4 and this relationship is dose-dependent, with more severe forms of undernutrition having a notably higher tuberculosis risk.5 Being undernourished is also a risk for higher rates of tuberculosis mortality and loss-to-follow-up among all genders and ages.6
