Prevalence of Tuberculosis and Related Factors among Malnourished Under-Five Children in a Therapeutic Feeding Center, Specialist Hospital, Sokoto, Nigeria

Prevalence of Tuberculosis and Related Factors among Malnourished Under-Five Children in a Therapeutic Feeding Center, Specialist Hospital, Sokoto, Nigeria | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Prevalence of Tuberculosis and Related Factors among Malnourished Under-Five Children in a Therapeutic Feeding Center, Specialist Hospital, Sokoto, Nigeria Abdulsalam Bello, Abdullahi Adamu Abugi, Aisha Abdulmutallab, and 4 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6844447/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 09 Sep, 2025 Read the published version in SN Comprehensive Clinical Medicine → Version 1 posted 10 You are reading this latest preprint version Abstract Background: Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium TB , primarily affecting the respiratory system but capable of involving other body systems. TB and malnutrition are major contributors to childhood morbidity and mortality in developing countries. This study aimed to assess the prevalence of TB in children with severe acute malnutrition (SAM) and identify associated factors among under-five children admitted to the In-Patient Therapeutic Feeding Center (ITFC) at Specialist Hospital Sokoto (SHS), Sokoto State. Materials and Methods: A cross-sectional study was conducted among 146 under-five children with SAM at ITFC, SHS. Data were collected using an interviewer-administered questionnaire via ODK and analyzed using IBM® SPSS version 26. Results: Most participants were aged 6–42 months, with a mean age of 17.14 months ± 7.0 SD. The prevalence of TB in the study was 5.5%. Findings indicated no significant association between TB and factors such as age, sex, low economic status, vaccination, exclusive breastfeeding, HIV infection, or place of residence (rural or urban). Conclusion: This study revealed a prevalence of TB among malnourished under-five children. Strengthening integrated TB prevention, screening, and nutritional rehabilitation strategies is recommended. Tuberculosis (TB) severe acute malnutrition (SAM) under-five children Sokoto 1.0 Introduction Tuberculosis (TB) is a highly infectious airborne disease caused by Mycobacterium tuberculosis and primarily affects the respiratory system. Although TB can involve other body systems, its transmission occurs through inhalation of infected aerosolized droplets [ 1 ]. Children, particularly those with compromised immunity due to malnutrition, are at high risk of developing active TB. The association between TB and malnutrition is bidirectional, as malnutrition weakens immune responses, increasing susceptibility to infections, while TB itself contributes to malnutrition through inflammation-induced weight loss and malabsorption. Severe Acute Malnutrition (SAM), characterized by wasting and kwashiorkor, is a major cause of childhood morbidity and mortality in low and middle-income countries. Malnourished children are more vulnerable to infections, including TB, due to impaired immune function [ 2 , 3 ]. Diagnosis of pediatric TB remains challenging due to the non-specific symptoms and limitations of current diagnostic tools. Clinical evaluation, radiographic findings, and confirmatory tests such as TB culture and nucleic acid amplification tests (NAAT) are used for diagnosis. Treatment of latent TB lasts between 3–9 months, while active TB therapy takes at least six months, with more severe forms requiring longer treatment durations [ 4 ]. The World Health Organization (WHO) reports that children constitute approximately 10–20% of total TB cases, with the highest burden in low-income regions. Despite the global End TB Strategy, which aims for significant reductions in TB incidence and mortality, childhood TB remains underdiagnosed and undertreated [ 5 ]. In 2021, Nigeria accounted for 4.4% of global TB cases, ranking among the highest burden countries [ 6 ]. Sokoto State had the highest estimated TB prevalence in Nigeria in 2016, highlighting the urgent need for targeted interventions [ 7 ]. This study aims to assess the prevalence of TB and associated factors among under-five malnourished children admitted to the In-Patient Therapeutic Feeding Center (ITFC) at Specialist Hospital Sokoto. Given the scarcity of research on childhood TB in the region, this study seeks to bridge the knowledge gap and provide data that can inform policies on TB prevention, early detection, and management in malnourished children. The study will explore the factors influencing TB prevalence, including socioeconomic conditions, immunization status, and comorbidities like HIV. The findings could support integrated TB screening and nutritional rehabilitation strategies to reduce childhood TB burden. 2.0 Methodology 2.1 Study Area and Population This cross-sectional study was conducted in Sokoto Metropolis, Sokoto State, located in northwestern Nigeria within the savannah vegetation zone. The state shares borders with the Republic of Niger, Zamfara, and Kebbi States, covering a land area of 28,232.37 square kilometers. The study population comprised under-five malnourished children admitted to the In-Patient Therapeutic Feeding Center (ITFC) at Specialist Hospital, Sokoto. Only children on admission during the study period were included; those attending outpatient clinics were excluded. 2.2 Ethical Consideration Institutional ethical clearance was obtained from the Ethical Committee of SHS, Nigeria with reference number SHS/SUB/133/VOL 1. 2.4 Sample size determination The sample size for the study was calculated using the formula n = (Z²pq) / d², where Z (1.96) is the standard normal value at a 95% confidence level, p (10.4% or 0.104) [8] is the prevalence of TB, q (1 - p = 0.896), and d (0.05) is the margin of error. This yielded a sample size of 143.2. However, the final sample size was 146. 2.5 Questionnaire development and Pretesting Data collection was conducted by research group members, and the questionnaire was pretested on 15 under-five malnourished children (10% of the sample population) at a primary healthcare facility in Sokoto. Necessary adjustments were made based on pretesting observations. Additionally, information on participants’ malnutrition status and TB was extracted from their case files. Data was collected using a semi-structured interviewer-administered questionnaire via Open Data Kit (ODK). 2.6 Statistical Analysis Data analysis was performed using IBM SPSS® version 25 statistical software. Quantitative variables were summarized as means and standard deviations, while qualitative variables were presented as frequencies and percentages. Frequency distribution tables were created, and cross-tabulations were conducted to assess relationships between categorical variables. The Chi-square test was used to identify factors associated with TB, with statistical significance set at p < 0.05. 3.0 Results 3.1 Characteristics of Respondents A total of 146 interviewer-administered questionnaires were completed by respondents at the ITFC, SHS, using Kobo Collect, resulting in a 100% response rate as shown in Table 1 . The mean age of the respondents was 17.14 month ± 7.0 years, with ages ranging from 6 to 42 months. The majority, 129 (88.4%), were between 6 and 24 months old. Males constituted 56.2% of the sample, and the Hausa ethnic group was predominant at 85.6%. All respondents were Muslims (100%), and most of their parents were married (93.2%). Quranic education was the most common educational background, with 69.2% of mothers and 45.2% of fathers having Quranic education. More than half of the respondents, 76 (52.1%), resided in urban areas. 3.2 Medical and immunization history of the respondents A total of 8 respondents (5.5%) were diagnosed with TB, with the majority, 129 (88.4%), aged between 6 and 24 months. More than two-thirds (72.6%) had no history of measles, while the majority, 139 (95.2%), had experienced diarrhea. Most respondents, 144 (98.6%), were HIV-negative, and a significant proportion, 112 (76.7%), had marasmus. Nearly two-thirds (60.3%) had received vaccinations, with 48.6% vaccinated at birth, while 61.6% had not received the measles vaccine as shown in Table 2 . 3.3 Nutritional, family and social history of the respondent More than two-thirds (78.8%) of the respondents were not exclusively breastfed, and about one-third (34.9%) started complementary feeding at six months. Additionally, 40.4% were not weaned. Regarding meal frequency, 46.6% had three square meals per day, while 1.4% were fed once, 5.5% twice, 37.7% four times, and 8.9% received breast milk on demand. The majority, 87 (60%), came from a monogamous family setting. Household sizes varied, with 34.2% living in houses with two bedrooms, while 33.6% had one bedroom, 18.5% had three, and 13.7% had more than three. Most respondents' rooms had two windows (52.1%), while 46.6% had one window and 1.4% had three. Additionally, 58.3% lived with one to three other persons in the same room. In terms of household income, 52.7% of families earned between 11,000 and 50,000 Naira (i.e. 6.9 and 31.25 dollars) as shown in Table 3 . 3.4 Anthropometric measurement of the respondents The weight distribution of the children shows that most (45.2%) weighed between 4.1–6.0 kg, followed by 34.9% in the 6.1–8.0 kg range, with fewer children weighing 2.0–4.0 kg (18.5%) or ≥ 8.1 kg (1.4%). In terms of height, the majority (80.8%) were between 61–80 cm tall, while 12.3% measured 40–60 cm, and 6.8% were ≥ 81 cm. 3.5 Association between sociodemographic characteristics of the respondents and TB TB was observed across all age groups, with a higher prevalence among children aged 6–24 months (11.8%). It was also slightly more common in males (6.1%), though these differences were not statistically significant (p = 0.226, p = 0.710, respectively). Children who were not exclusively breastfed had a higher prevalence of TB, while prevalence remained equal across different residences; however, neither factor showed statistical significance (p = 0.789, p = 0.905). Notably, TB cases were more frequent among those with no family history of the disease, and this finding approached statistical significance (p = 0.06) as shown in Table 4 . 3.6 Association between medical, immunization and TB Respondents with marasmus had a higher number of TB cases; however, this was not statistically significant (p = 0.334), similar to the history of measles (p = 0.510). In contrast, a history of diarrhea was found to be statistically significant (p = 0.006). Additionally, BCG vaccination, measles vaccination, and HIV status did not show statistical significance (p = 0.394, p = 0.464, p = 0.732, respectively) as shown in Table 5 . 4.0 Discussion Children remain one of the most vulnerable populations, particularly suffering from malnutrition in developing, low-income countries. This ongoing malnutrition significantly increases their susceptibility to infectious diseases, especially TB, which is challenging to treat due to its prolonged medication regimen. This heightened vulnerability is often linked to a lack of access to a balanced, nutrient-rich diet essential for the proper development of the immune system [2,3,14], . In Nigeria, Sokoto, a key state in the northern region faces widespread poverty, leading to high rates of malnutrition among children. Despite this, the connection between malnutrition and TB in this area has not received sufficient attention. This gap motivated the current research to explore the relationship between malnutrition and TB, particularly in children under five years old. In our study, we assessed the prevalence of TB and its associated factors among children with SAM under five years old at the ITFC, SHS, finding a TB prevalence of 5.5%. This rate is somewhat higher than that reported in a similar study by Atalell et al. [8] in Dire Dawa, Eastern Ethiopia. A much higher prevalence of 20% was found in a study by Ide [9] at the Children’s Hospital in Freetown, Sierra Leone. In a retrospective follow-up study by Aynalem et al. [10], the incidence was 4.6 per 100 person-day observations, while Shruthi [11] reported a prevalence of 10.34%. However, a lower prevalence of 1.6% was observed in a study [12] from Lusaka, Zambia. These regions are among those most affected by malnutrition in children, particularly in South-East Asia with emphasis on India and across Africa. In many of these countries, data on TB in malnourished children are still lacking, and numerous cases go unreported. The variation in prevalence is influenced by several factors, one major issue being the lack of effective surveillance policies. Additionally, with poverty at its peak in many areas, some families are unable to bring their children to hospitals, and cases may go undetected until after the child has died [13]. The majority of these participants are under 2 years old, falling within the critical age range of 6 to 24 months, a vital period for immune system development. This makes them highly susceptible to TB, especially considering that many also suffer from SAM, with males being slightly more affected than females. Most of these children belong to the Hausa ethnic group. Even those who are not Hausa typically come from tribes closely related to the Hausa, and the general population lacks Western education but has strong Islamic knowledge. Although most participants live in urban areas, these places still retain characteristics of rural settlements. For example, some families continue to live in mud houses, where domestic animals particularly cattle are kept nearby. These animals can carry a specific type of tuberculosis called Mycobacterium bovis , which can be transmitted to humans through constant interaction and consumption of milk from these cattles [15]. While there has been significant progress in several childhood vaccination programs especially for children under the age of five, as shown in Table 2, this progress is largely due to government outreach initiatives rather than routine hospital visits. These programs involve health workers visiting homes to ensure children receive vaccinations. Although some vaccines have been administered through these efforts, many others have yet to be given including the BCG vaccines. If these children were regularly brought to the hospital, there would be a greater chance of detecting infections like tuberculosis early, particularly in malnourished children. The latent nature of TB means a mother can be infected without showing any symptoms. However, with continuous exposure to the bacteria, there may be activation of the disease, which could lead to transmission through breastfeeding and regular close contact, as the baby is always with the mother [17]. Although the majority of participants indicated that the babies were consuming three or more square meals daily, the nutritional content of the milk or food especially for those who have begun complementary feeding may be inadequate. This could be due to insufficient feeding by the mother, on whom the children heavily depend. Several possible risk factors, including age, sex, and others, showed no association with the chances of children with SAM being affected by TB. Nonetheless, TB infection and other illnesses in children can often be detected early in malnourished children, particularly those with SAM. Poverty continues to be a major factor contributing to these problems. A large proportion of the families live on between $6.90 and $31.25 per week, which is far from sufficient to support their basic needs. This highlights the urgent need for interventions, assistance, and medical support to achieve a lasting solution. 5.0 Conclusion This study highlights the concerning intersection of SAM and TB among children under five in Sokoto, Nigeria. These findings highlights the impact of poverty, poor nutrition, and limited healthcare access on child health. Despite ongoing vaccination efforts, gaps remain in routine medical care and early TB detection, particularly in malnourished children. The study reinforces the urgent need for integrated interventions combining nutritional support, TB surveillance, and community-based healthcare outreach to reduce morbidity and mortality in this high-risk group. Declarations Acknowledgement. All authors would like to express their gratitude to everyone who contributed to this study. Funding This research received no funding. Conflict of Interest The authors declare that they have no conflicts of interest. Ethical Consideration This study involved human participants. Ethical Approval The study protocol was approved by the Ethical Committee of Specialist Hospital Sokoto, Nigeria, with reference number SHS/SUB/133/VOL 1. Consent to participate Informed consent was obtained from all individual participants included in the study. Written Consent for Publication Not applicable.\ Availability of Data and Material All data and materials used in this study are available upon reasonable request, except for those deemed confidential. Code Availability Not applicable. Authors’ Contributions AB, AAA, AA: Conceptualization, Data Analyses, Resources, Writing-Original draft, Writing-Reviewing. AOU: Writing-Original draft, Writing-Reviewing. HA, IM: Writing-Original draft, Writing-Reviewing. MB, AA: Supervision, Writing-Original draft, Writing-Reviewing. UMA: Conceptualization, Data Analyses, Resources, Supervision, Writing-Original draft, Writing-Reviewing. References Bloom, B. R., Atun, R., Cohen, T., et al. (2017). Tuberculosis. In K. K. Holmes, S. Bertozzi, B. R. Bloom, et al. (Eds.), Major infectious diseases (3rd ed., Chap. 11). The International Bank for Reconstruction and Development / The World Bank. https://www.ncbi.nlm.nih.gov/books/NBK525174/ https://doi.org/10.1596/978-1-4648-0524-0_ch11 Ter Beek, L., Alffenaar, J.-W. C., Bolhuis, M. S., van der Werf, T. S., & Akkerman, O. W. (2019). Tuberculosis-related malnutrition: Public health implications. 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Prevalence and molecular mapping of multidrug-resistant Mycobacterium tuberculosis in Sokoto, North-Western Nigeria. Avicenna Journal of Clinical Microbiology and Infection , 9 (3), 97–102. https://doi.org/10.34172/ajcmi.2022.3390 Atalell, K. A., Haile, R. N., & Techane, M. A. (2022). Magnitude of tuberculosis and its associated factors among under-five children admitted with severe acute malnutrition to public hospitals in the city of Dire Dawa, Eastern Ethiopia, 2021: Multi-center cross-sectional study. IJID Regions , 3 , 256–260. https://doi.org/10.1016/j.ijregi.2022.04.008 Ide, L. E. Y. (2019). Prevalence of tuberculosis among children with severe acute malnutrition at Ola during Children’s Hospital in Freetown, Sierra Leone. Journal of Advances in Medicine and Medical Research , 30 (3), 1–7. https://doi.org/10.9734/JAMMR/2019/v30i330179 Aynalem, Y. A., Getacher, L., Ashene, Y. E., Akalu, T. Y., Yitbarek, G. Y., Ayele, F. Y., Aklilu, D., Marfo, E. A., Alene, T., & Shiferaw, W. S. 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Journal of Clinical Tuberculosis and Other Mycobacterial Diseases , 27 , 100311. https://doi.org/10.1016/j.jctube.2022.100311 Morales, F., Montserrat-de la Paz, S., León, M. J., & Rivero-Pino, F. (2023). Effects of malnutrition on the immune system and infection and the role of nutritional strategies regarding improvements in children's health status: A literature review. Nutrients , 16 (1), 1. https://doi.org/10.3390/nu16010001 Allen, A. R., Ford, T., & Skuce, R. A. (2021). Does Mycobacterium tuberculosis var. bovis survival in the environment confound bovine tuberculosis control and eradication? A literature review. Veterinary Medicine International, 2021 , 8812898. https://doi.org/10.1155/2021/8812898 Dimova, T., Terzieva, A., Djerov, L., Dimitrova, V., Nikolov, A., Grozdanov, P., & Markova, N. (2017). Mother-to-newborn transmission of mycobacterial L-forms and Vδ2 T-cell response in placentobiome of BCG-vaccinated pregnant women. 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Scientific Reports , 7 , Article 17366. https://doi.org/10.1038/s41598-017-17644-z Tables Table 1 Sociodemographic characteristics of the respondents Variable Frequency (n = 146) Percentage (%) Age (months) 6–24 25–42 129 17 88.4 11.6 Sex Male Female 82 64 56.2 43.8 Tribe Hausa Fulani Others* (Zarma) 125 18 3 85.6 12.3 2.1 Religion Islam Christianity 146 0 100 0 Marital status Married Divorced Others** 136 6 3 93.2 4.1 2.1 Mother’s level of education None Primary Secondary Tertiary Quranic 14 17 10 4 101 9.6 11.6 6.8 2.7 69.2 Father’s level of education None Primary Secondary Tertiary Quranic 7 7 39 27 66 4.8 4.8 26.7 18.5 45.2 Place of residence Urban Rural 76 70 52.1 47.9 others*- Zarma others**- caregivers Table 2 Medical and immunization history of the respondents Variable Frequency (n = 146) Percentage (%) TB status Yes No 8 138 5.5 94.5 Age at TB diagnosis 6–24 25–42 129 17 88.4 11.6 History of measles Yes No 40 106 27.4 72.6 History of diarrhoea Yes No 139 7 95.2 4.8 HIV status Positive Negative 2 144 1.4 98.6 Type of malnutrition Marasmus Kwashiorkor Marasmic-kwashiorkor Underweight 112 9 23 2 76.7 6.2 15.8 1.4 TB vaccinated status Yes No 88 58 60.3 39.7 Time of vaccination At birth Within 1 year Not vaccinated 71 17 58 48.6 11.6 39.7 Measles vaccination status Yes No 56 90 38.4 61.6 Table 3 Nutritional, family and social history of the respondent Variable Frequency (n = 146) Percentage (%) Exclusive breastfeeding Yes No 31 115 21.2 78.8 Complimentary feed initiation At 6 months Others 51 95 34.9 65.1 Weaning 0–6 7–12 13–18 19–24 Not weaned 6 11 26 44 59 4.2 7.5 17.8 30.1 40.4 Frequency of meals per day 1 2 3 4 Breast milk only 2 8 68 55 13 1.4 5.5 46.6 37.7 8.9 Family history of TB Yes No 7 139 4.8 95.2 Family setting Monogamy Polygamy 87 58 60 40 House setting 1 bedroom 2 bedrooms 3 bedrooms Others (> 3 bedrooms) 49 50 27 20 33.6 34.2 18.5 13.7 Number of windows per room 1 2 3 68 76 2 46.6 52.1 1.4 Number of occupants per room 1–3 4–6 7–9 76 60 10 58.3 41.1 6.8 Family income ≤ 10000 11000–50000 51000–100000 101000–150000 > 150000 12 77 38 8 11 8.2 52.7 26 5.5 7.5 Table 4 Association between sociodemographic characteristics of the respondents and TB Variables TB status Test statistic p-value Yes (n = 8) n (%) No (n = 138) n (%) Age (years) 6–24 ≥ 25 6 (4.7) 2 (11.8) 123 (95.3) 15 (88.2) \(\:{{\chi\:}}^{2}\) = 1.468 p = 0.226 Sex Male 5 (6.1) 77 (93.9 \(\:{{\chi\:}}^{2}\) = 0.138 Female 3 (4.7) 61 (95.3) p = 0.710 Exclusive breastfeeding Yes No 2 (6.5) 6 (5.2) 29 (93.5) 109 (94.8) \(\:{{\chi\:}}^{2}\) = 0.072 P = 0.789 Place of residence Urban Rural 4 (5.3) 4 (5.7) 72 (94.7) 66 (94.3) \(\:{{\chi\:}}^{2}\) = 0.014 P = 0.905 Family history of TB Yes No 2 (28.6) 6 (4.3) 5 (71.4) 133 (95.7) \(\:{{\chi\:}}^{2}\) = 7.570 P = 0.06 \(\:{\varvec{\chi\:}}^{2}\) = Pearson’s Chi-square test p= P-value Table 5 Association between medical, immunization and TB Variables TB status Test statistic p-value Yes (n = 8) n (%) No (n = 138) n (%) Type of malnutrition Marasmus 5 (4.5) 107 (95.5) Kwashiorkor 0 (0) 9 (100) \(\:{{\chi\:}}^{2}\) = 3.401 Marasmic-Kwashiorkor 3 (13) 20 (87) p = 0.334 Underweight 0 (0) 2 (100) History of measles Yes No 3 (7.5) 5 (4.7) 37 (92.5) 101 (95.3) \(\:{{\chi\:}}^{2}=0.434\) p = 0.510 History of diarrhea Yes No 6 (4.3%) 2 (28.6%) 133 (95.7%) 5 (71.4%) \(\:{{\chi\:}}^{2}=7.570\) p = 0.006 BCG Immunization Yes 6 (6.8) 82 (93.2) \(\:{{\chi\:}}^{2}\) = 0.727 No 2 (3.5) 55 (96.5) p = 0.394 Measles vaccination Yes 2 (3.6) 54 (96.4) \(\:{{\chi\:}}^{2}\) = 0.639 No 6 (6.7) 84 (93.3) p = 0.464 HIV status Yes 0 (0) 2 (100) \(\:{{\chi\:}}^{2}\) = 0.118 No 8 (5.6) 136 (94.4) p = 0.732 Additional Declarations No competing interests reported. Supplementary Files Table1.docx Table2.docx Table3.docx Table4.docx Table5.docx SupplementaryMaterial.docx Cite Share Download PDF Status: Published Journal Publication published 09 Sep, 2025 Read the published version in SN Comprehensive Clinical Medicine → Version 1 posted Editorial decision: Revision requested 16 Jul, 2025 Reviews received at journal 14 Jul, 2025 Reviews received at journal 12 Jul, 2025 Reviewers agreed at journal 11 Jul, 2025 Reviewers agreed at journal 07 Jul, 2025 Reviewers agreed at journal 07 Jul, 2025 Reviewers invited by journal 07 Jul, 2025 Editor assigned by journal 13 Jun, 2025 Submission checks completed at journal 13 Jun, 2025 First submitted to journal 07 Jun, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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University","correspondingAuthor":false,"prefix":"","firstName":"Makun","middleName":"","lastName":"Babazhitsu","suffix":""},{"id":481836005,"identity":"61efebdd-ecfb-4fdf-b6d3-1a8b140d7c26","order_by":5,"name":"Asmau Adamu","email":"","orcid":"","institution":"Usmanu Danfodiyo University Teaching Hospital","correspondingAuthor":false,"prefix":"","firstName":"Asmau","middleName":"","lastName":"Adamu","suffix":""},{"id":481836006,"identity":"27ed99ff-610d-4cc6-b1bd-281aed94ce1d","order_by":6,"name":"Umar Muhammad Ango","email":"","orcid":"","institution":"Usmanu Danfodiyo University","correspondingAuthor":false,"prefix":"","firstName":"Umar","middleName":"Muhammad","lastName":"Ango","suffix":""}],"badges":[],"createdAt":"2025-06-07 19:23:15","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6844447/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6844447/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s42399-025-02057-1","type":"published","date":"2025-09-09T15:57:22+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":91358997,"identity":"399585d6-5cac-446b-97c4-937fc9e4ca10","added_by":"auto","created_at":"2025-09-15 16:03:49","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1411232,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6844447/v1/b5c242d9-7bc6-47af-b59f-da965521bf70.pdf"},{"id":86264129,"identity":"ae764d5b-427a-42cd-9525-3df56d91b0f6","added_by":"auto","created_at":"2025-07-08 15:22:41","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":13323,"visible":true,"origin":"","legend":"","description":"","filename":"Table1.docx","url":"https://assets-eu.researchsquare.com/files/rs-6844447/v1/d94a5c96fa2f7d83ef950922.docx"},{"id":86263792,"identity":"8aa6e1e6-593d-48a6-aaa4-85af11043b34","added_by":"auto","created_at":"2025-07-08 15:14:41","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":13163,"visible":true,"origin":"","legend":"","description":"","filename":"Table2.docx","url":"https://assets-eu.researchsquare.com/files/rs-6844447/v1/376074b824297898b2fc0a1e.docx"},{"id":86264727,"identity":"a9bdf5b3-d4a1-4718-aee7-b1862cf28265","added_by":"auto","created_at":"2025-07-08 15:30:41","extension":"docx","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":13546,"visible":true,"origin":"","legend":"","description":"","filename":"Table3.docx","url":"https://assets-eu.researchsquare.com/files/rs-6844447/v1/7ba069b1ebf909a6c8b75124.docx"},{"id":86264726,"identity":"389fe2fc-5c98-432a-a5ae-107fad08a033","added_by":"auto","created_at":"2025-07-08 15:30:41","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":13346,"visible":true,"origin":"","legend":"","description":"","filename":"Table4.docx","url":"https://assets-eu.researchsquare.com/files/rs-6844447/v1/679b00bbf37af71e20a9eb41.docx"},{"id":86263791,"identity":"926b7961-113d-4ca6-a1cb-c343b01bc79a","added_by":"auto","created_at":"2025-07-08 15:14:41","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":13703,"visible":true,"origin":"","legend":"","description":"","filename":"Table5.docx","url":"https://assets-eu.researchsquare.com/files/rs-6844447/v1/241df51bd165f578c4c4500e.docx"},{"id":86263800,"identity":"4c197f3a-4ea5-4744-b6a8-96e0280d76d9","added_by":"auto","created_at":"2025-07-08 15:14:41","extension":"docx","order_by":5,"title":"","display":"","copyAsset":false,"role":"supplement","size":520305,"visible":true,"origin":"","legend":"","description":"","filename":"SupplementaryMaterial.docx","url":"https://assets-eu.researchsquare.com/files/rs-6844447/v1/76322b48c90ff324a9b12d85.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Prevalence of Tuberculosis and Related Factors among Malnourished Under-Five Children in a Therapeutic Feeding Center, Specialist Hospital, Sokoto, Nigeria","fulltext":[{"header":"1.0 Introduction","content":"\u003cp\u003eTuberculosis (TB) is a highly infectious airborne disease caused by \u003cem\u003eMycobacterium tuberculosis\u003c/em\u003e and primarily affects the respiratory system. Although TB can involve other body systems, its transmission occurs through inhalation of infected aerosolized droplets [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Children, particularly those with compromised immunity due to malnutrition, are at high risk of developing active TB. The association between TB and malnutrition is bidirectional, as malnutrition weakens immune responses, increasing susceptibility to infections, while TB itself contributes to malnutrition through inflammation-induced weight loss and malabsorption. Severe Acute Malnutrition (SAM), characterized by wasting and kwashiorkor, is a major cause of childhood morbidity and mortality in low and middle-income countries. Malnourished children are more vulnerable to infections, including TB, due to impaired immune function [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Diagnosis of pediatric TB remains challenging due to the non-specific symptoms and limitations of current diagnostic tools. Clinical evaluation, radiographic findings, and confirmatory tests such as TB culture and nucleic acid amplification tests (NAAT) are used for diagnosis. Treatment of latent TB lasts between 3\u0026ndash;9 months, while active TB therapy takes at least six months, with more severe forms requiring longer treatment durations [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. The World Health Organization (WHO) reports that children constitute approximately 10\u0026ndash;20% of total TB cases, with the highest burden in low-income regions. Despite the global End TB Strategy, which aims for significant reductions in TB incidence and mortality, childhood TB remains underdiagnosed and undertreated [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In 2021, Nigeria accounted for 4.4% of global TB cases, ranking among the highest burden countries [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Sokoto State had the highest estimated TB prevalence in Nigeria in 2016, highlighting the urgent need for targeted interventions [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. This study aims to assess the prevalence of TB and associated factors among under-five malnourished children admitted to the In-Patient Therapeutic Feeding Center (ITFC) at Specialist Hospital Sokoto. Given the scarcity of research on childhood TB in the region, this study seeks to bridge the knowledge gap and provide data that can inform policies on TB prevention, early detection, and management in malnourished children. The study will explore the factors influencing TB prevalence, including socioeconomic conditions, immunization status, and comorbidities like HIV. The findings could support integrated TB screening and nutritional rehabilitation strategies to reduce childhood TB burden.\u003c/p\u003e"},{"header":"2.0 Methodology","content":"\u003cp\u003e\u003cstrong\u003e2.1 Study Area and Population\u003c/strong\u003e This cross-sectional study was conducted in Sokoto Metropolis, Sokoto State, located in northwestern Nigeria within the savannah vegetation zone. The state shares borders with the Republic of Niger, Zamfara, and Kebbi States, covering a land area of 28,232.37 square kilometers. The study population comprised under-five malnourished children admitted to the In-Patient Therapeutic Feeding Center (ITFC) at Specialist Hospital, Sokoto. Only children on admission during the study period were included; those attending outpatient clinics were excluded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.2 Ethical Consideration\u003c/strong\u003e Institutional ethical clearance was obtained from the Ethical Committee of SHS, Nigeria with reference number SHS/SUB/133/VOL 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.4 Sample size determination\u003c/strong\u003e The sample size for the study was calculated using the formula n = (Z\u0026sup2;pq) / d\u0026sup2;, where Z (1.96) is the standard normal value at a 95% confidence level, p (10.4% or 0.104) [8] is the prevalence of TB, q (1 - p\u0026thinsp;=\u0026thinsp;0.896), and d (0.05) is the margin of error. This yielded a sample size of 143.2. However, the final sample size was 146.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.5 Questionnaire development and Pretesting\u003c/strong\u003e Data collection was conducted by research group members, and the questionnaire was pretested on 15 under-five malnourished children (10% of the sample population) at a primary healthcare facility in Sokoto. Necessary adjustments were made based on pretesting observations. Additionally, information on participants\u0026rsquo; malnutrition status and TB was extracted from their case files. Data was collected using a semi-structured interviewer-administered questionnaire via Open Data Kit (ODK).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e2.6 Statistical Analysis\u003c/strong\u003e Data analysis was performed using IBM SPSS\u0026reg; version 25 statistical software. Quantitative variables were summarized as means and standard deviations, while qualitative variables were presented as frequencies and percentages. Frequency distribution tables were created, and cross-tabulations were conducted to assess relationships between categorical variables. The Chi-square test was used to identify factors associated with TB, with statistical significance set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"3.0 Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 Characteristics of Respondents\u003c/strong\u003e A total of 146 interviewer-administered questionnaires were completed by respondents at the ITFC, SHS, using Kobo Collect, resulting in a 100% response rate as shown in Table \u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e. The mean age of the respondents was 17.14 month\u0026thinsp;\u0026plusmn;\u0026thinsp;7.0 years, with ages ranging from 6 to 42 months. The majority, 129 (88.4%), were between 6 and 24 months old. Males constituted 56.2% of the sample, and the Hausa ethnic group was predominant at 85.6%. All respondents were Muslims (100%), and most of their parents were married (93.2%). Quranic education was the most common educational background, with 69.2% of mothers and 45.2% of fathers having Quranic education. More than half of the respondents, 76 (52.1%), resided in urban areas.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 Medical and immunization history of the respondents\u003c/strong\u003e A total of 8 respondents (5.5%) were diagnosed with TB, with the majority, 129 (88.4%), aged between 6 and 24 months. More than two-thirds (72.6%) had no history of measles, while the majority, 139 (95.2%), had experienced diarrhea. Most respondents, 144 (98.6%), were HIV-negative, and a significant proportion, 112 (76.7%), had marasmus. Nearly two-thirds (60.3%) had received vaccinations, with 48.6% vaccinated at birth, while 61.6% had not received the measles vaccine as shown in Table \u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.3 Nutritional, family and social history of the respondent\u003c/strong\u003e More than two-thirds (78.8%) of the respondents were not exclusively breastfed, and about one-third (34.9%) started complementary feeding at six months. Additionally, 40.4% were not weaned. Regarding meal frequency, 46.6% had three square meals per day, while 1.4% were fed once, 5.5% twice, 37.7% four times, and 8.9% received breast milk on demand. The majority, 87 (60%), came from a monogamous family setting. Household sizes varied, with 34.2% living in houses with two bedrooms, while 33.6% had one bedroom, 18.5% had three, and 13.7% had more than three. Most respondents' rooms had two windows (52.1%), while 46.6% had one window and 1.4% had three. Additionally, 58.3% lived with one to three other persons in the same room. In terms of household income, 52.7% of families earned between 11,000 and 50,000 Naira (i.e. 6.9 and 31.25 dollars) as shown in Table \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.4 Anthropometric measurement of the respondents\u003c/strong\u003e The weight distribution of the children shows that most (45.2%) weighed between 4.1\u0026ndash;6.0 kg, followed by 34.9% in the 6.1\u0026ndash;8.0 kg range, with fewer children weighing 2.0\u0026ndash;4.0 kg (18.5%) or \u0026ge;\u0026thinsp;8.1 kg (1.4%). In terms of height, the majority (80.8%) were between 61\u0026ndash;80 cm tall, while 12.3% measured 40\u0026ndash;60 cm, and 6.8% were \u0026ge;\u0026thinsp;81 cm.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.5 Association between sociodemographic characteristics of the respondents and TB\u003c/strong\u003e TB was observed across all age groups, with a higher prevalence among children aged 6\u0026ndash;24 months (11.8%). It was also slightly more common in males (6.1%), though these differences were not statistically significant (p\u0026thinsp;=\u0026thinsp;0.226, p\u0026thinsp;=\u0026thinsp;0.710, respectively). Children who were not exclusively breastfed had a higher prevalence of TB, while prevalence remained equal across different residences; however, neither factor showed statistical significance (p\u0026thinsp;=\u0026thinsp;0.789, p\u0026thinsp;=\u0026thinsp;0.905). Notably, TB cases were more frequent among those with no family history of the disease, and this finding approached statistical significance (p\u0026thinsp;=\u0026thinsp;0.06) as shown in Table \u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.6 Association between medical, immunization and TB\u003c/strong\u003e Respondents with marasmus had a higher number of TB cases; however, this was not statistically significant (p\u0026thinsp;=\u0026thinsp;0.334), similar to the history of measles (p\u0026thinsp;=\u0026thinsp;0.510). In contrast, a history of diarrhea was found to be statistically significant (p\u0026thinsp;=\u0026thinsp;0.006). Additionally, BCG vaccination, measles vaccination, and HIV status did not show statistical significance (p\u0026thinsp;=\u0026thinsp;0.394, p\u0026thinsp;=\u0026thinsp;0.464, p\u0026thinsp;=\u0026thinsp;0.732, respectively) as shown in Table \u003cspan class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e"},{"header":"4.0 Discussion","content":"\u003cp\u003eChildren remain one of the most vulnerable populations, particularly suffering from malnutrition in developing, low-income countries. This ongoing malnutrition significantly increases their susceptibility to infectious diseases, especially TB, which is challenging to treat due to its prolonged medication regimen. This heightened vulnerability is often linked to a lack of access to a balanced, nutrient-rich diet essential for the proper development of the immune system [2,3,14], . In Nigeria, Sokoto, a key state in the northern region faces widespread poverty, leading to high rates of malnutrition among children. Despite this, the connection between malnutrition and TB in this area has not received sufficient attention. This gap motivated the current research to explore the relationship between malnutrition and TB, particularly in children under five years old.\u003c/p\u003e\n\u003cp\u003eIn our study, we assessed the prevalence of TB and its associated factors among children with SAM under five years old at the ITFC, SHS, finding a TB prevalence of 5.5%. This rate is somewhat higher than that reported in a similar study by Atalell et al. [8] in Dire Dawa, Eastern Ethiopia. A much higher prevalence of 20% was found in a study by Ide [9] at the Children\u0026rsquo;s Hospital in Freetown, Sierra Leone. In a retrospective follow-up study by Aynalem et al. [10], the incidence was 4.6 per 100 person-day observations, while Shruthi [11] reported a prevalence of 10.34%. However, a lower prevalence of 1.6% was observed in a study [12] from Lusaka, Zambia. These regions are among those most affected by malnutrition in children, particularly in South-East Asia with emphasis on India and across Africa. In many of these countries, data on TB in malnourished children are still lacking, and numerous cases go unreported. The variation in prevalence is influenced by several factors, one major issue being the lack of effective surveillance policies. Additionally, with poverty at its peak in many areas, some families are unable to bring their children to hospitals, and cases may go undetected until after the child has died [13].\u003c/p\u003e\n\u003cp\u003eThe majority of these participants are under 2 years old, falling within the critical age range of 6 to 24 months, a vital period for immune system development. This makes them highly susceptible to TB, especially considering that many also suffer from SAM, with males being slightly more affected than females. Most of these children belong to the Hausa ethnic group. Even those who are not Hausa typically come from tribes closely related to the Hausa, and the general population lacks Western education but has strong Islamic knowledge. Although most participants live in urban areas, these places still retain characteristics of rural settlements. For example, some families continue to live in mud houses, where domestic animals particularly cattle are kept nearby. These animals can carry a specific type of tuberculosis called \u003cem\u003eMycobacterium bovis\u003c/em\u003e, which can be transmitted to humans through constant interaction and consumption of milk from these cattles [15].\u003c/p\u003e\n\u003cp\u003eWhile there has been significant progress in several childhood vaccination programs especially for children under the age of five, as shown in Table 2, this progress is largely due to government outreach initiatives rather than routine hospital visits. These programs involve health workers visiting homes to ensure children receive vaccinations. Although some vaccines have been administered through these efforts, many others have yet to be given including the BCG vaccines. If these children were regularly brought to the hospital, there would be a greater chance of detecting infections like tuberculosis early, particularly in malnourished children. \u0026nbsp;The latent nature of TB means a mother can be infected without showing any symptoms. However, with continuous exposure to the bacteria, there may be activation of the disease, which could lead to transmission through breastfeeding and regular close contact, as the baby is always with the mother [17]. Although the majority of participants indicated that the babies were consuming three or more square meals daily, the nutritional content of the milk or food especially for those who have begun complementary feeding may be inadequate. This could be due to insufficient feeding by the mother, on whom the children heavily depend. Several possible risk factors, including age, sex, and others, showed no association with the chances of children with SAM being affected by TB. Nonetheless, TB infection and other illnesses in children can often be detected early in malnourished children, particularly those with SAM. Poverty continues to be a major factor contributing to these problems. A large proportion of the families live on between $6.90 and $31.25 per week, which is far from sufficient to support their basic needs. This highlights the urgent need for interventions, assistance, and medical support to achieve a lasting solution.\u003c/p\u003e"},{"header":"5.0 Conclusion","content":"\u003cp\u003eThis study highlights the concerning intersection of SAM and TB among children under five in Sokoto, Nigeria. These findings highlights the impact of poverty, poor nutrition, and limited healthcare access on child health. Despite ongoing vaccination efforts, gaps remain in routine medical care and early TB detection, particularly in malnourished children. The study reinforces the urgent need for integrated interventions combining nutritional support, TB surveillance, and community-based healthcare outreach to reduce morbidity and mortality in this high-risk group.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgement.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll authors would like to express their gratitude to everyone who contributed to this study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research received no funding.\u003c/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no conflicts of interest.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Consideration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study involved human participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe study protocol was approved by the Ethical Committee of\u0026nbsp;Specialist Hospital Sokoto, Nigeria, with reference number SHS/SUB/133/VOL 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all individual participants included in the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eWritten Consent for Publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\\\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of Data and Material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data and materials used in this study are available upon reasonable request, except for those deemed confidential.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCode Availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAB, AAA, AA:\u003c/strong\u003e Conceptualization, Data Analyses, Resources, Writing-Original draft, Writing-Reviewing. \u003cstrong\u003eAOU:\u0026nbsp;\u003c/strong\u003eWriting-Original draft, Writing-Reviewing. \u003cstrong\u003eHA, IM:\u0026nbsp;\u003c/strong\u003eWriting-Original draft, Writing-Reviewing.\u003cstrong\u003e\u0026nbsp;MB, AA:\u003c/strong\u003e Supervision, Writing-Original draft, Writing-Reviewing.\u003cstrong\u003e\u0026nbsp;UMA:\u003c/strong\u003e Conceptualization, Data Analyses, Resources, Supervision, Writing-Original draft, Writing-Reviewing.\u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBloom, B. R., Atun, R., Cohen, T., et al. (2017). Tuberculosis. In K. K. Holmes, S. Bertozzi, B. R. Bloom, et al. (Eds.), \u003cem\u003eMajor infectious diseases\u003c/em\u003e (3rd ed., Chap. 11). The International Bank for Reconstruction and Development / The World Bank. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ncbi.nlm.nih.gov/books/NBK525174/\u003c/span\u003e\u003cspan address=\"https://www.ncbi.nlm.nih.gov/books/NBK525174/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1596/978-1-4648-0524-0_ch11\u003c/span\u003e\u003cspan address=\"10.1596/978-1-4648-0524-0_ch11\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTer Beek, L., Alffenaar, J.-W. C., Bolhuis, M. S., van der Werf, T. S., \u0026amp; Akkerman, O. W. (2019). Tuberculosis-related malnutrition: Public health implications. \u003cem\u003eThe Journal of Infectious Diseases\u003c/em\u003e, \u003cem\u003e220\u003c/em\u003e(2), 340\u0026ndash;341. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1093/infdis/jiz091\u003c/span\u003e\u003cspan address=\"10.1093/infdis/jiz091\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGupta, K. B., Gupta, R., Atreja, A., Verma, M., \u0026amp; Vishvkarma, S. (2009). Tuberculosis and nutrition. \u003cem\u003eLung India\u003c/em\u003e, \u003cem\u003e26\u003c/em\u003e(1), 9\u0026ndash;16. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4103/0970-2113.45198\u003c/span\u003e\u003cspan address=\"10.4103/0970-2113.45198\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCenters for Disease Control and Prevention. (2025). \u003cem\u003eClinical and laboratory diagnosis\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.cdc.gov/tb/hcp/testing-diagnosis/clinical-and-laboratory-diagnosis.html\u003c/span\u003e\u003cspan address=\"https://www.cdc.gov/tb/hcp/testing-diagnosis/clinical-and-laboratory-diagnosis.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. (2013). \u003cem\u003eRoadmap for childhood tuberculosis: Towards zero deaths\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://apps.who.int/iris/bitstream/handle/10665/89506/9789241506137_eng.pdf\u003c/span\u003e\u003cspan address=\"https://apps.who.int/iris/bitstream/handle/10665/89506/9789241506137_eng.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eWorld Health Organization. (2022). \u003cem\u003e2.1 TB incidence\u003c/em\u003e. In \u003cem\u003eGlobal tuberculosis report 2022\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2022/tb-disease-burden/2-1-tb-incidence\u003c/span\u003e\u003cspan address=\"https://www.who.int/teams/global-programme-on-tuberculosis-and-lung-health/tb-reports/global-tuberculosis-report-2022/tb-disease-burden/2-1-tb-incidence\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHudu, S. A., Jimoh, A. O., \u0026amp; Mohammed, Y. (2022). Prevalence and molecular mapping of multidrug-resistant \u003cem\u003eMycobacterium tuberculosis\u003c/em\u003e in Sokoto, North-Western Nigeria. \u003cem\u003eAvicenna Journal of Clinical Microbiology and Infection\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(3), 97\u0026ndash;102. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.34172/ajcmi.2022.3390\u003c/span\u003e\u003cspan address=\"10.34172/ajcmi.2022.3390\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAtalell, K. A., Haile, R. N., \u0026amp; Techane, M. A. (2022). Magnitude of tuberculosis and its associated factors among under-five children admitted with severe acute malnutrition to public hospitals in the city of Dire Dawa, Eastern Ethiopia, 2021: Multi-center cross-sectional study. \u003cem\u003eIJID Regions\u003c/em\u003e, \u003cem\u003e3\u003c/em\u003e, 256\u0026ndash;260. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ijregi.2022.04.008\u003c/span\u003e\u003cspan address=\"10.1016/j.ijregi.2022.04.008\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIde, L. E. Y. (2019). Prevalence of tuberculosis among children with severe acute malnutrition at Ola during Children\u0026rsquo;s Hospital in Freetown, Sierra Leone. \u003cem\u003eJournal of Advances in Medicine and Medical Research\u003c/em\u003e, \u003cem\u003e30\u003c/em\u003e(3), 1\u0026ndash;7. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.9734/JAMMR/2019/v30i330179\u003c/span\u003e\u003cspan address=\"10.9734/JAMMR/2019/v30i330179\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAynalem, Y. A., Getacher, L., Ashene, Y. E., Akalu, T. Y., Yitbarek, G. Y., Ayele, F. Y., Aklilu, D., Marfo, E. A., Alene, T., \u0026amp; Shiferaw, W. S. (2023). \u003cem\u003eIncidence of tuberculosis and its predictors among under-five children with severe acute malnutrition in North Shoa, Amhara region, Ethiopia: A retrospective follow-up study\u003c/em\u003e. \u003cem\u003eFrontiers in Pediatrics, 11\u003c/em\u003e, Article 1134822. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3389/fped.2023.1134822\u003c/span\u003e\u003cspan address=\"10.3389/fped.2023.1134822\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShruthi, S., Ratageri, V. H., Shivananda, I., Shilpa, C., \u0026amp; Wari, P. K. (2019). \u003cem\u003ePulmonary tuberculosis in children with severe acute malnutrition: A prospective hospital-based study\u003c/em\u003e. \u003cem\u003ePediatric Infectious Disease\u003c/em\u003e, \u003cem\u003e1\u003c/em\u003e(1), 1\u0026ndash;3. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5005/jp-journals-10081-1101\u003c/span\u003e\u003cspan address=\"10.5005/jp-journals-10081-1101\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMunthali, T., Chabala, C., Chama, E., Mugode, R., Kapata, N., Musonda, P., \u0026amp; Michelo, C. (2017). \u003cem\u003eTuberculosis caseload in children with severe acute malnutrition related with high hospital-based mortality in Lusaka, Zambia\u003c/em\u003e. \u003cem\u003eBMC Research Notes\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e, 206. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s13104-017-2529-5\u003c/span\u003e\u003cspan address=\"10.1186/s13104-017-2529-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCarwile, M. E., Hochberg, N. S., \u0026amp; Sinha, P. (2022). Undernutrition is feeding the tuberculosis pandemic: A perspective. \u003cem\u003eJournal of Clinical Tuberculosis and Other Mycobacterial Diseases\u003c/em\u003e, \u003cem\u003e27\u003c/em\u003e, 100311. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.jctube.2022.100311\u003c/span\u003e\u003cspan address=\"10.1016/j.jctube.2022.100311\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMorales, F., Montserrat-de la Paz, S., Le\u0026oacute;n, M. J., \u0026amp; Rivero-Pino, F. (2023). Effects of malnutrition on the immune system and infection and the role of nutritional strategies regarding improvements in children's health status: A literature review. \u003cem\u003eNutrients\u003c/em\u003e, \u003cem\u003e16\u003c/em\u003e(1), 1. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/nu16010001\u003c/span\u003e\u003cspan address=\"10.3390/nu16010001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAllen, A. R., Ford, T., \u0026amp; Skuce, R. A. (2021). Does \u003cem\u003eMycobacterium tuberculosis\u003c/em\u003e var. \u003cem\u003ebovis\u003c/em\u003e survival in the environment confound bovine tuberculosis control and eradication? A literature review. \u003cem\u003eVeterinary Medicine International, 2021\u003c/em\u003e, 8812898. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1155/2021/8812898\u003c/span\u003e\u003cspan address=\"10.1155/2021/8812898\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDimova, T., Terzieva, A., Djerov, L., Dimitrova, V., Nikolov, A., Grozdanov, P., \u0026amp; Markova, N. (2017). Mother-to-newborn transmission of mycobacterial L-forms and Vδ2 T-cell response in placentobiome of BCG-vaccinated pregnant women. \u003cem\u003eScientific Reports\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e, 17366. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1038/s41598-017-17644-z\u003c/span\u003e\u003cspan address=\"10.1038/s41598-017-17644-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDimova, T., Terzieva, A., Djerov, L., Dimitrova, V., Nikolov, A., Grozdanov, P., \u0026amp; Markova, N. (2017). Mother-to-newborn transmission of mycobacterial L-forms and Vδ2 T-cell response in placentobiome of BCG-vaccinated pregnant women. \u003cem\u003eScientific Reports\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e, Article 17366. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1038/s41598-017-17644-z\u003c/span\u003e\u003cspan address=\"10.1038/s41598-017-17644-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv class=\"gridtable\"\u003e\n \u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eSociodemographic characteristics of the respondents\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 55.102%;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 21.8659%;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;146)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 55.102%;\"\u003e\n \u003cp\u003eAge (months)\u003c/p\u003e\n \u003cp\u003e6\u0026ndash;24\u003c/p\u003e\n \u003cp\u003e25\u0026ndash;42\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 21.8659%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e88.4\u003c/p\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 55.102%;\"\u003e\n \u003cp\u003eSex\u003c/p\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 21.8659%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e82\u003c/p\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e56.2\u003c/p\u003e\n \u003cp\u003e43.8\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 55.102%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTribe\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eHausa\u003c/p\u003e\n \u003cp\u003eFulani\u003c/p\u003e\n \u003cp\u003eOthers* (Zarma)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 21.8659%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e125\u003c/p\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e85.6\u003c/p\u003e\n \u003cp\u003e12.3\u003c/p\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 55.102%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReligion\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eIslam\u003c/p\u003e\n \u003cp\u003eChristianity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 21.8659%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e146\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 55.102%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003cp\u003eOthers**\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 21.8659%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e93.2\u003c/p\u003e\n \u003cp\u003e4.1\u003c/p\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 55.102%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMother\u0026rsquo;s level of education\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003cp\u003eTertiary\u003c/p\u003e\n \u003cp\u003eQuranic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 21.8659%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003e101\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e9.6\u003c/p\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003cp\u003e6.8\u003c/p\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003cp\u003e69.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 55.102%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFather\u0026rsquo;s level of education\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eNone\u003c/p\u003e\n \u003cp\u003ePrimary\u003c/p\u003e\n \u003cp\u003eSecondary\u003c/p\u003e\n \u003cp\u003eTertiary\u003c/p\u003e\n \u003cp\u003eQuranic\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 21.8659%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003cp\u003e26.7\u003c/p\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003cp\u003e45.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 55.102%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of residence\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 21.8659%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e52.1\u003c/p\u003e\n \u003cp\u003e47.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003ctfoot\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003e\u003cstrong\u003eothers*-\u003c/strong\u003e Zarma\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\"\u003e\u003cstrong\u003eothers**-\u003c/strong\u003e caregivers\u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tfoot\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab2\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eMedical and immunization history of the respondents\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;146)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003eTB status\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e138\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003cp\u003e94.5\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003eAge at TB diagnosis\u003c/p\u003e\n \u003cp\u003e6\u0026ndash;24\u003c/p\u003e\n \u003cp\u003e25\u0026ndash;42\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e88.4\u003c/p\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistory of measles\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e27.4\u003c/p\u003e\n \u003cp\u003e72.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistory of diarrhoea\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e95.2\u003c/p\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHIV status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003ePositive\u003c/p\u003e\n \u003cp\u003eNegative\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e144\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003cp\u003e98.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eType of malnutrition\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMarasmus\u003c/p\u003e\n \u003cp\u003eKwashiorkor\u003c/p\u003e\n \u003cp\u003eMarasmic-kwashiorkor\u003c/p\u003e\n \u003cp\u003eUnderweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e112\u003c/p\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e76.7\u003c/p\u003e\n \u003cp\u003e6.2\u003c/p\u003e\n \u003cp\u003e15.8\u003c/p\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTB vaccinated status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e88\u003c/p\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e60.3\u003c/p\u003e\n \u003cp\u003e39.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime of vaccination\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eAt birth\u003c/p\u003e\n \u003cp\u003eWithin 1 year\u003c/p\u003e\n \u003cp\u003eNot vaccinated\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e71\u003c/p\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e48.6\u003c/p\u003e\n \u003cp\u003e11.6\u003c/p\u003e\n \u003cp\u003e39.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 54.1419%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMeasles vaccination status\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 22.1895%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e56\u003c/p\u003e\n \u003cp\u003e90\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e38.4\u003c/p\u003e\n \u003cp\u003e61.6\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab3\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eNutritional, family and social history of the respondent\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eFrequency\u003c/p\u003e\n \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;146)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003ePercentage\u003c/p\u003e\n \u003cp\u003e(%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eExclusive breastfeeding\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003cp\u003e115\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e21.2\u003c/p\u003e\n \u003cp\u003e78.8\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eComplimentary feed initiation\u003c/p\u003e\n \u003cp\u003eAt 6 months\u003c/p\u003e\n \u003cp\u003eOthers\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e95\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e34.9\u003c/p\u003e\n \u003cp\u003e65.1\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eWeaning\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0\u0026ndash;6\u003c/p\u003e\n \u003cp\u003e7\u0026ndash;12\u003c/p\u003e\n \u003cp\u003e13\u0026ndash;18\u003c/p\u003e\n \u003cp\u003e19\u0026ndash;24\u003c/p\u003e\n \u003cp\u003eNot weaned\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003cp\u003e44\u003c/p\u003e\n \u003cp\u003e59\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e4.2\u003c/p\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003cp\u003e17.8\u003c/p\u003e\n \u003cp\u003e30.1\u003c/p\u003e\n \u003cp\u003e40.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequency of meals per day\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003cp\u003eBreast milk only\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003cp\u003e46.6\u003c/p\u003e\n \u003cp\u003e37.7\u003c/p\u003e\n \u003cp\u003e8.9\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history of TB\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e139\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e4.8\u003c/p\u003e\n \u003cp\u003e95.2\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily setting\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMonogamy\u003c/p\u003e\n \u003cp\u003ePolygamy\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e87\u003c/p\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003cp\u003e40\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHouse setting\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1 bedroom\u003c/p\u003e\n \u003cp\u003e2 bedrooms\u003c/p\u003e\n \u003cp\u003e3 bedrooms\u003c/p\u003e\n \u003cp\u003eOthers (\u0026gt;\u0026thinsp;3 bedrooms)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e33.6\u003c/p\u003e\n \u003cp\u003e34.2\u003c/p\u003e\n \u003cp\u003e18.5\u003c/p\u003e\n \u003cp\u003e13.7\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of windows per room\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e68\u003c/p\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e46.6\u003c/p\u003e\n \u003cp\u003e52.1\u003c/p\u003e\n \u003cp\u003e1.4\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eNumber of occupants per room\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e1\u0026ndash;3\u003c/p\u003e\n \u003cp\u003e4\u0026ndash;6\u003c/p\u003e\n \u003cp\u003e7\u0026ndash;9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e76\u003c/p\u003e\n \u003cp\u003e60\u003c/p\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e58.3\u003c/p\u003e\n \u003cp\u003e41.1\u003c/p\u003e\n \u003cp\u003e6.8\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily income\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026le;\u0026thinsp;10000\u003c/p\u003e\n \u003cp\u003e11000\u0026ndash;50000\u003c/p\u003e\n \u003cp\u003e51000\u0026ndash;100000\u003c/p\u003e\n \u003cp\u003e101000\u0026ndash;150000\u003c/p\u003e\n \u003cp\u003e\u0026gt;\u0026thinsp;150000\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e8.2\u003c/p\u003e\n \u003cp\u003e52.7\u003c/p\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003cp\u003e5.5\u003c/p\u003e\n \u003cp\u003e7.5\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u003cbr\u003e\u003c/div\u003e\n \u003ctable id=\"Tab4\" border=\"1\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eAssociation between sociodemographic characteristics of the respondents and TB\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth rowspan=\"2\" align=\"left\" style=\"width: 32.5397%;\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\" style=\"width: 31.5476%;\"\u003e\n \u003cp\u003eTB status\u003c/p\u003e\n \u003c/th\u003e\n \u003cth rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eTest statistic\u003c/p\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 14.4841%;\"\u003e\n \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;8)\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;138)\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\" style=\"width: 32.5397%;\"\u003e\n \u003cp\u003eAge (years)\u003c/p\u003e\n \u003cp\u003e6\u0026ndash;24\u003c/p\u003e\n \u003cp\u003e\u0026ge;\u0026thinsp;25\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\" style=\"width: 14.4841%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e6 (4.7)\u003c/p\u003e\n \u003cp\u003e2 (11.8)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e123 (95.3)\u003c/p\u003e\n \u003cp\u003e15 (88.2)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e = 1.468\u003c/p\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.226\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 32.5397%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 14.4841%;\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 32.5397%;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 14.4841%;\"\u003e\n \u003cp\u003e5 (6.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e77 (93.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e = 0.138\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 32.5397%;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 14.4841%;\"\u003e\n \u003cp\u003e3 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e61 (95.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.710\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 32.5397%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExclusive breastfeeding\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 14.4841%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e2 (6.5)\u003c/p\u003e\n \u003cp\u003e6 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e29 (93.5)\u003c/p\u003e\n \u003cp\u003e109 (94.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e= 0.072\u003c/p\u003e\n \u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.789\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 32.5397%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePlace of residence\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eUrban\u003c/p\u003e\n \u003cp\u003eRural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 14.4841%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e4 (5.3)\u003c/p\u003e\n \u003cp\u003e4 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e72 (94.7)\u003c/p\u003e\n \u003cp\u003e66 (94.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e= 0.014\u003c/p\u003e\n \u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.905\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\" style=\"width: 32.5397%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFamily history of TB\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\" style=\"width: 14.4841%;\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e2 (28.6)\u003c/p\u003e\n \u003cp\u003e6 (4.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e5 (71.4)\u003c/p\u003e\n \u003cp\u003e133 (95.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e= 7.570\u003c/p\u003e\n \u003cp\u003eP\u0026thinsp;=\u0026thinsp;0.06\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" align=\"left\"\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{\\varvec{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e\u003cstrong\u003e= Pearson\u0026rsquo;s Chi-square test p= P-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n \u003cdiv class=\"colspec\" align=\"left\"\u003e\u0026nbsp;\u003c/div\u003e\n \u003ctable id=\"Tab5\" border=\"1\" class=\"fr-table-selection-hover\"\u003e\n \u003ccaption\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eAssociation between medical, immunization and TB\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eVariables\u003c/p\u003e\n \u003c/th\u003e\n \u003cth colspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eTB status\u003c/p\u003e\n \u003c/th\u003e\n \u003cth rowspan=\"2\" align=\"left\"\u003e\n \u003cp\u003eTest statistic\u003c/p\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eYes (n\u0026thinsp;=\u0026thinsp;8)\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNo (n\u0026thinsp;=\u0026thinsp;138)\u003c/p\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eType of malnutrition\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarasmus\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e5 (4.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e107 (95.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eKwashiorkor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e9 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e = 3.401\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMarasmic-Kwashiorkor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e3 (13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e20 (87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.334\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eUnderweight\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistory of measles\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e3 (7.5)\u003c/p\u003e\n \u003cp\u003e5 (4.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e37 (92.5)\u003c/p\u003e\n \u003cp\u003e101 (95.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}=0.434\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.510\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHistory of diarrhea\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e6 (4.3%)\u003c/p\u003e\n \u003cp\u003e2 (28.6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e133 (95.7%)\u003c/p\u003e\n \u003cp\u003e5 (71.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}=7.570\\)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.006\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eBCG Immunization\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (6.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e82 (93.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e = 0.727\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e55 (96.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.394\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eMeasles vaccination\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (3.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e54 (96.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e= 0.639\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e6 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e84 (93.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.464\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003eHIV status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003ctd align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e2 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\:{{\\chi\\:}}^{2}\\)\u003c/span\u003e\u003c/span\u003e= 0.118\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e8 (5.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e136 (94.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.732\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"sn-comprehensive-clinical-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sncm","sideBox":"Learn more about [SN Comprehensive Clinical Medicine](https://www.springer.com/journal/42399)","snPcode":"42399","submissionUrl":"https://submission.nature.com/new-submission/42399/3","title":"SN Comprehensive Clinical Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Tuberculosis (TB), severe acute malnutrition (SAM), under-five children, Sokoto","lastPublishedDoi":"10.21203/rs.3.rs-6844447/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6844447/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eTuberculosis (TB) is a chronic infectious disease caused by \u003cem\u003eMycobacterium TB\u003c/em\u003e, primarily affecting the respiratory system but capable of involving other body systems. TB and malnutrition are major contributors to childhood morbidity and mortality in developing countries. This study aimed to assess the prevalence of TB in children with severe acute malnutrition (SAM) and identify associated factors among under-five children admitted to the In-Patient Therapeutic Feeding Center (ITFC) at Specialist Hospital Sokoto (SHS), Sokoto State.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMaterials and Methods: \u003c/strong\u003eA cross-sectional study was conducted among 146 under-five children with SAM at ITFC, SHS. Data were collected using an interviewer-administered questionnaire via ODK and analyzed using IBM® SPSS version 26.\u003cstrong\u003e \u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eMost participants were aged 6–42 months, with a mean age of 17.14 months ± 7.0 SD. The prevalence of TB in the study was 5.5%. Findings indicated no significant association between TB and factors such as age, sex, low economic status, vaccination, exclusive breastfeeding, HIV infection, or place of residence (rural or urban).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThis study revealed a prevalence of TB among malnourished under-five children. Strengthening integrated TB prevention, screening, and nutritional rehabilitation strategies is recommended.\u003c/p\u003e","manuscriptTitle":"Prevalence of Tuberculosis and Related Factors among Malnourished Under-Five Children in a Therapeutic Feeding Center, Specialist Hospital, Sokoto, Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-08 15:14:36","doi":"10.21203/rs.3.rs-6844447/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-07-16T09:36:37+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-14T08:56:33+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-12T22:28:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"35939704120376006032495375832144768013","date":"2025-07-11T10:35:14+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"292942383184965581124307824727439935008","date":"2025-07-07T14:11:27+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"48919514950378563635206797723142024699","date":"2025-07-07T07:23:18+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-07-07T05:26:22+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-06-13T17:27:03+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-06-13T17:09:44+00:00","index":"","fulltext":""},{"type":"submitted","content":"SN Comprehensive Clinical Medicine","date":"2025-06-07T19:11:03+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"sn-comprehensive-clinical-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"sncm","sideBox":"Learn more about [SN Comprehensive Clinical Medicine](https://www.springer.com/journal/42399)","snPcode":"42399","submissionUrl":"https://submission.nature.com/new-submission/42399/3","title":"SN Comprehensive Clinical Medicine","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"9617ac05-91fa-486d-b2bc-b16b189bee96","owner":[],"postedDate":"July 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-09-15T15:59:45+00:00","versionOfRecord":{"articleIdentity":"rs-6844447","link":"https://doi.org/10.1007/s42399-025-02057-1","journal":{"identity":"sn-comprehensive-clinical-medicine","isVorOnly":false,"title":"SN Comprehensive Clinical Medicine"},"publishedOn":"2025-09-09 15:57:22","publishedOnDateReadable":"September 9th, 2025"},"versionCreatedAt":"2025-07-08 15:14:36","video":"","vorDoi":"10.1007/s42399-025-02057-1","vorDoiUrl":"https://doi.org/10.1007/s42399-025-02057-1","workflowStages":[]},"version":"v1","identity":"rs-6844447","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6844447","identity":"rs-6844447","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}