• A multicentric cohort study was conducted, based on the body mass index (BMI) of household contacts (HHCs) of people with TB diagnosed within 2 months of the study date.

• The study had 857 HHCs, 239 (27.9%) of whom were underweight according to their BMI.

• Out of the 18 new TB cases that developed during follow-up, 10 cases were underweight, and all 4 participants who developed early TB disease were severely malnourished.

• The study found a hazard ratio of 3.16 (95% confidence interval, 1.25 to 8.02) for TB disease in undernourished household contacts.

• The study concluded that undernourished individuals are at heightened risk of progression, not infection.

• In addition to TB preventive therapy, the study highlights the significance of TB programs in preventing tuberculosis (TB) among household contacts by providing sufficient rations for the entire household.

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