Accepted for/Published in: Asian/Pacific Island Nursing Journal
Date Submitted: Aug 5, 2025
Open Peer Review Period: Aug 13, 2025 - Oct 8, 2025
Date Accepted: Dec 31, 2025
(closed for review but you can still tweet)
Effect of Body Mass Index on Mortality in Patients with Tuberculosis and HIV Co-Infection within the Scope of Asia Africa: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
In 2022, an estimated 10.6 million people developed tuberculosis (TB) globally, with 6.3% co-infected with HIV. The Southeast Asia region accounted for 46% of global TB cases, while Africa contributed 23%. TB-HIV co-infection remains a major cause of death, with 167,000 deaths recorded among co-infected individuals in 2022. Nutritional status, particularly Body Mass Index (BMI), may influence mortality in this population. However, no comprehensive synthesis of the evidence currently exists.
Objective:
To assess the association between BMI and mortality among TB-HIV co-infected patients in Asia and Africa.
Methods:
A systematic review and meta-analysis of cohort studies published between 2000 and 2024 were conducted using PubMed, Scopus, and ProQuest. A random-effects model was applied to calculate pooled Risk Ratio (RR) and 95% confidence intervals.
Results:
Eleven cohort studies met the inclusion criteria. Patients with low BMI (<18.5 kg/m²) had a 10% higher risk of mortality compared to those with normal or higher BMI (RR = 0.90; 95% CI: 0.86–0.94; p < 0.05). Heterogeneity was substantial (I² = 78%), but the association remained statistically significant and robust.
Conclusions:
Low BMI is significantly associated with increased mortality among TB-HIV co-infected patients in Asia and Africa. Routine nutritional screening and targeted support should be prioritized in TB-HIV clinical management strategies. Clinical Trial: This systematic review and meta-analysis has been registered with the Open Science Framework (doi: 10.17605/OSF.IO/74QWH).
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