Background: Tuberculosis (TB) in children remains a major public health problem, particularly among vulnerable age groups such as children under five years old. Poor nutritional status is considered one of the important host factors that may increase susceptibility to TB infection. This study aimed to determine the relationship between nutritional status and the incidence of tuberculosis among children aged 1–5 years in Jember Regency, Indonesia.
Materials and Methods: This analytical observational study employed a retrospective case-control design, adhering to STROBE guidelines. Data were obtained from 16 Primary Health Centers (Puskesmas) in Jember Regency in 2025. The sample (n=214) included 107 children aged 1–5 years diagnosed with TB and 107 age-and sex-matched controls. Anthropometric status was assessed using WHO Z-score standards for weight-for-height (WHZ), weight-for-age (WAZ), and height-for-age (HAZ). Potential confounders, including feeding history (breastfeeding vs. formula), pre-existing anemia (Hb <11 g/dL), and secondary comorbidities, were analyzed. Data were analyzed using Chi-Square and binary logistic regression to adjust for expression bias and isolate the effect of nutritional status.
Results: The results showed a significant relationship between nutritional status and tuberculosis incidence among children. Based on the BB/TB indicator, children with poor nutritional status had a 2.68 times higher risk of developing tuberculosis compared to children with normal nutritional status (χ² = 9.054; p = 0.003; OR = 2.684; 95% CI: 1.934–5.169). Significant associations were also found for BB/U (p = 0.001) and TB/U (p = 0.002).
Conclusion: Nutritional status is significantly associated with the incidence of tuberculosis in children aged 1–5 years. Improving nutritional status should be integrated into tuberculosis prevention and control programs to reduce TB risk among young children.