Abstract / Summary
Background: Tuberculosis (TB) remains a major public health challenge, with nutritional status playing an important role in treatment outcomes and recovery. While nutrition-related knowledge, attitudes and practices (KAP) may influence dietary behaviours and nutritional well-being, evidence on their relationship with BMI status among people receiving TB treatment remains limited.Objective: To explore the relationship between body mass index (BMI) and nutrition-related knowledge, attitudes and practices (KAP) among people receiving TB treatment in the eThekwini District.Methods: A cross-sectional study was conducted among 385 adults receiving TB treatment at selected primary health care (PHC) facilities. Data were collected between August and November 2025 through a semi-structured interviewer-administered questionnaire that assessed sociodemographic characteristics, nutrition-related knowledge, attitudes and practices, as well as dietary intake patterns. Height and weight measurements were used to calculate body mass index (BMI), which was used as an indicator for nutritional status in this study and was categorised as underweight, normal or overweight/obese via anthropometric measurement using the World Health Organization’s (WHO) formula for BMI.Pearson’s chi-square test was used to assess bivariate associations between participant characteristics and BMI categories. Multinomial logistic regression analyses were performed to identify factors associated with BMI categories, using normal BMI as the reference category. Crude and adjusted relative risk ratios (RRRs) with 95% confidence intervals (CIs) were estimated.Results: Of the 385 participants, 17% were underweight, 67% had normal BMI and 16% were overweight/obese. Bivariate analyses showed that BMI categories were associated with age group, marital status, employment status and nutrition knowledge. In adjusted multinomial regression analyses, low nutrition knowledge remained significantly associated with underweight status relative to normal BMI (aRRR = 0.52, 95% CI: 0.28–0.95). No significant association was observed between nutrition knowledge and overweight/obese BMI status. Nutrition attitudes and practices were not significantly associated with BMI categories after adjustment for potential confounders.Conclusion: Low nutrition knowledge was independently associated with underweight status among people receiving TB treatment, while no link was found with overweight or obesity. Further research is needed to better understand this relationship.