A daily multiple micronutrient supplement at 1×
recommended nutrient intake should be provided
in situations where fortified or supplementary foods
should have been provided in accordance with
standard management of moderate undernutrition
but are unavailable.

Patients with active multidrug-resistant TB and
moderate undernutrition should be provided with
locally available nutrient-rich or fortified supplementary
foods, as necessary to restore normal nutritional status.

Pregnant women with active TB and moderate
undernutrition, or with inadequate weight gain,
should be provided with locally available nutrient-rich or fortified supplementary foods, as necessary to
achieve an average weekly minimum weight gain of
approximately 300 g in the second and third trimesters.

Children who are less than 5 years of age with active
TB and moderate undernutrition should be managed
as any other children with moderate undernutrition.
This includes provision of locally available nutrient-rich or fortified supplementary foods, in order to
restore appropriate weight-for-height.

School-age children and adolescents (5 to 19 years),
and adults, including lactating women, with active
TB and moderate undernutrition, who fail to
regain normal body mass index after 2 months of TB
treatment, as well as those who are losing weight
during TB treatment, should be evaluated for
adherence and comorbid conditions. They should
also receive nutrition assessment and counselling
and, if indicated, be provided with locally available
nutrient-rich or fortified supplementary foods as

Children who are less than 5 years of age with active
TB and severe acute malnutrition should be treated
in accordance with the WHO recommendations for
the management of severe acute malnutrition in
children who are less than 5 years of age.

Sschool-age children and adolescents (5 to 19 years),
and adults, including pregnant and lactating women,
with active TB and severe acute malnutrition should
be treated in accordance with the WHO
recommendations for management of severe acute
malnutrition.

In settings where contact tracing is implemented,
household contacts of people with active TB should
have a nutrition screening and assessment as part of
contact investigation. If malnutrition is identified,
it should be managed according to WHO
recommendations.

All lactating women with active TB should be
provided with iron and folic acid and other
vitamins and minerals, according to the United
Nations Multiple Micronutrient Preparation, to
complement their maternal micronutrient needs.

For pregnant women with active TB in settings where
calcium intake is low, calcium supplementation
as part of antenatal care is recommended for
the prevention of pre-eclampsia, particularly
among those pregnant women at higher risk of
developing hypertension, in accordance with WHO
recommendations.