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Tuberculosis prevalence among children with severe acute malnutrition is 13% (95% CI: 11-16%)Tuberculosis is common among children with severe acute malnutrition

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Key Takeaway
Note that 13% of children with severe acute malnutrition have tuberculosis, with higher rates in Southern Africa.

This meta-analysis evaluates the prevalence of tuberculosis (TB) among children under 15 years of age diagnosed with severe acute malnutrition (SAM). The analysis included data from 33,869 children across 15 countries, primarily in sub-Saharan Africa and South Asia. The study identifies a pooled TB prevalence of 13% (95% CI: 11-16%) among the sampled population.

Key findings indicate significant geographic and environmental variations. Specifically, the prevalence of TB in Southern Africa was reported at 36% (95% CI: 19-56%; p<0.01), which is higher than other regions. Additionally, children with a history of household exposure showed a significantly higher prevalence of TB (74%) compared to those without such exposure (17%) (p=0.01).

The authors note substantial heterogeneity in the data (I2=98%). These findings suggest that integrated TB screening and early diagnosis are critical components for hospital-based SAM care pathways. Clinical application is limited by the high degree of statistical heterogeneity reported in the pooled prevalence figures.

How this fits prior evidence

This meta-analysis addresses a gap in understanding the intersection of malnutrition and tuberculosis in pediatric populations. While prior coverage has focused on diagnostic tools like WGS-based tests for resistance, mobile applications to improve treatment success, and specific drug regimens such as rifapentine, this study provides data on the baseline prevalence of TB specifically within the high-risk cohort of children with severe acute malnutrition.

When a child suffers from severe acute malnutrition (SAM), their body is already fighting a massive uphill battle. New data shows that many of these children are also fighting another invisible enemy: tuberculosis (TB). This double burden makes it even harder for the youngest patients to recover and stay healthy.

Researchers looked at 33,869 children under age 15 across 15 countries. They found that about 13% of children with severe acute malnutrition also had TB. The risk was much higher in certain areas, such as Southern Africa, where the prevalence reached 36%. The data also showed a clear link to environment: children who had someone with TB in their household were much more likely to have the infection themselves.

While these numbers are high, there is a lot of variation in the data across different regions. Because of this inconsistency, the findings suggest that doctors should look for both conditions at once. By integrating TB screening into standard care for malnourished children, healthcare providers can catch infections earlier and provide better support to those who need it most.

What this means for you:
Over 13% of children with severe acute malnutrition also have tuberculosis, especially in certain regions.

Common questions

How common is tuberculosis in children with severe malnutrition?

The study found that approximately 13% of children under age 15 with severe acute malnutrition also had tuberculosis. This means that a significant number of these children are fighting two serious conditions at the same time.

Does where a child lives affect their risk of having both conditions?

Yes, location matters. The study found a much higher rate of tuberculosis in Southern Africa, where 36% of children with severe acute malnutrition also had the infection.

Does living with someone who has TB increase risk for malnourished children?

Yes, household exposure is a major factor. Children who had a history of someone with tuberculosis in their home were much more likely to have it than those without such exposure.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedAug 2026
View Original Abstract ↓
Introduction: Control of tuberculosis (TB) in children remains a major challenge globally. There is growing recognition that children with severe acute malnutrition (SAM) are a high-risk population for TB, but the global burden of TB in this group has never been comprehensively quantified. Methods: We conducted a systematic review and meta-analysis to estimate the prevalence of TB among children with SAM. Following PRISMA guidelines, we searched PubMed/MEDLINE, Embase, Scopus, Web of Science, Cochrane Library, and WHO Global Index Medicus from database inception to June 15, 2026. We included studies reporting TB among systematically sampled cohorts of children <15 years with SAM as defined by the World Health Organization. Methodological study quality was assessed with adapted versions of the Newcastle-Ottawa Scale or the Joanna Briggs Institute critical appraisal checklist. Pooled TB prevalence was calculated using a random-effects model with predefined stratification of studies by geographic region, national TB incidence, and study quality. We also conducted subgroup analyses by age, sex, HIV status, SAM type, and TB exposure. Results: We included 73 studies comprising 33,869 children with SAM across 15 countries, predominantly from sub-Saharan Africa and South Asia, and predominantly reporting on hospitalized children. The pooled TB prevalence was 13% (95% CI: 11-16%), but there was substantial heterogeneity (I2=98%). Studies conducted in Southern Africa had the highest pooled TB prevalence (36%, 95% CI: 19-56%) compared to other regions (p<0.01). Pooled TB prevalence was higher in those with history of TB household exposure compared to those without (74% vs. 17%, p=0.01). Conclusions: Approximately one in eight children hospitalized with SAM have TB, greatest among children with history of TB exposure and those in Southern Africa. These findings highlight opportunities for improved early TB diagnosis and routine, integrated TB screening within hospital-based SAM care pathways.
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