Nutritional interventions and Their Impact on Tuberculosis Treatment Outcomes in Tanzania: A Systematic Review of interventional and operational studies

BackgroundTuberculosis (TB) is a major public health challenge in developing countries, where Tanzania is one of them. The presence of under-nutrition exacerbates disease progression and impairs treatment outcomes. Nutritional support has been increasingly recognized as a vital component of TB care, yet the evidence from interventional and operational studies remains fragmented. This systematic review aims to synthesize current evidence on the impact of nutritional interventions on TB treatment outcomes and recovery in Tanzania. MethodsA comprehensive literature search was conducted across major databases including PubMed, Embase, Scopus, Web of Science and others which covered studies published from January 2000 to June 2025. Eligible studies included randomized controlled trials, quasi-experimental designs, and operational research evaluating the effect of nutritional interventions, such as food supplements, micronutrient support, and therapeutic feeding on TB treatment outcomes (eg. cure rate, treatment completion, mortality) and recovery indicators (e.g., weight gain, immune response) among TB patients in developing countries. Risks of bias and study quality were assessed using standardized tools. ResultsA total of 18 studies involving approximately 5007 participants are included, the majority of which reported positive associations between nutritional interventions and improved treatment outcomes including: higher treatment completion rates, enhanced weight gain, and reduced mortality. Micronutrient supplementation showed variable effects, while macronutrient and food-based interventions demonstrated more consistent benefits. Operational studies revealed challenges in implementation and sustainability, particularly in resource-limited settings. ConclusionsNutritional interventions play a critical role in enhancing TB treatment success and patient recovery. Integrating tailored nutritional support into routine TB care could improve health outcomes. Further large-scale, high-quality operational studies are needed to guide policy and program implementation.