Abstract
OBJECTIVE: To decipher the role of body mass index (BMI) measured at treatment initiation on mortality rates in tuberculosis (TB). METHODS: This PROSPERO-registered PRISMA compliant review searched PubMed, Embase, CENTRAL, and Web of Science for studies from inception upto 10(th) June 2024. Studies on adult patients examining mortality rates in TB patients based on BMI at treatment initiation were included. We analyzed crude and adjusted mortality rates in a random-effects meta-analysis model. Data was pooled to generate odds ratio (OR) and 95% confidence intervals (CI). RESULTS: Ten studies were included. Both crude (OR: 2.54 95% CI: 2.13, 3.03 I(2)=56%) and adjusted (OR: 1.99 95% CI: 1.63, 2.44 I(2)=68%) data analysis showed that low BMI (<18.5 kg/m(2)) at treatment initiation was a significant factor increasing mortality rates of TB. Meta-analysis of crude data (OR: 1.07 95% CI: 0.68, 1.69 I(2)=76%) did not demonstrate a significant association between high BMI and mortality, but adjusted data showed that high BMI was associated with significantly reduced risk of mortality in TB patients (OR: 0.79 95% CI: 0.66, 0.95 I(2)=10%). CONCLUSIONS: Low BMI is associated with a significantly increased risk of mortality in TB patients. Scarce evidence also suggests that a high BMI may offer better survival rates for TB.