The prevalence of underweight among TB patients was 57.17 %; the prevalence of underweight among TB free residents was 23.37 %. This proportion was statistically significant (X2 565.8, P-value <0.01). This finding indicates that 33.8 % excess malnutrition was observed as a result of tuberculosis. This is because TB infection increases the anabolic process and consumes additional energy[37], additionally, TB infection manifests with a reduction in appetite, nutrient malabsorption, finally increasing the risk of underweight [38].
The prevalence of anemia among TB patients was 88.52 %; the prevalence of anemia among TB free residents was 51.78 %. TB patients had 36.74 % excess burden of anemia as compared to the residents. This results was statistically significant at X2 656.7 p-vale <0.01. This is due to the effect of TB on red blood cell production like decreasing the erythrocyte lifespan, poor erythrocyte iron incorporation, and decreased sensitivity to or supply of erythropoietin[39].
The odds of malnutrition among extra pulmonary TB patients were 47 % higher than pulmonary TB patients. This finding was in line with finding from Nepal [40]. This is due to the reason that the diagnosis of extra-pulmonary TB is not easy as compared to pulmonary TB and patients were not early detected for the intervention [41]The odds of malnutrition were 2.5 times higher in female TB patients.. This finding agrees with finding from Ghana [15]. This is due to the reason that the severity of TB was more virulent in female [42]. Additionally Male could have better access to food compared to female who might need to prioritize their families, especially their children.
The odds of malnutrition among TB patients were 3.84 folds higher in the urban areas. This finding disagrees with finding from India [43]. This is due to the reason that most urban residents in Ethiopia were living in the overcrowded condition [44].
The odds of malnutrition were 7 folds higher among intestinal parasites positive TB patients. This finding agrees with finding from Butajira [45]. This is due to the fact that intestinal parasites decrease the food intake, interfere with the absorption of nutrients and also they share the host nutrients [46].
Alcoholic TB patients had 1.52 folds higher risk of malnutrition. This finding agrees with research finding from Tanzania [47]. This is due to the reason that alcoholic patients eat poorly, had poor digestion, storage, utilization, and excretion of nutrients [48].
Anemia increases the odds of malnutrition by 3.23 folds. This finding agrees with finding from Brazil [49]. This is due to the effect of red blood cells in the transportation of nutrients and minerals [50].
The odds of malnutrition were 3.23 folds higher among tuberculosis patients whose age was greater than 25 years. This finding agrees with finding from Ghana [34]. This is due to the reason that the risk of co morbid illness like non-communicable diseases was the higher age [51].
The odds of malnutrition were 1.96 folds higher among HIV positive TB patients. This finding agrees with finding from Tanzania [47]. This is due to the reason that HIV positive patients were not economically productive so that they can’t get the access to the different variety of foods [52], HIV positive patients have a poor appetite, poor absorption of nutrients [53, 54].
The odds of malnutrition were 15.75 folds higher among TB patients with high family size. This finding agrees with finding from India [15]. This is due to the fact that high family size decreases the household income leading to the low dietary intake of household members [55].
Believe in avoiding a certain types of food increase the odds of malnutrition by 3.19 folds higher. This finding was in line with finding from Ghana[56]. This is due to the reason that patients will not take important nutrients due to their behavior of avoiding that type of food [57].
Family size and believe in avoiding a certain type of food were not the predictors of malnutrition among the tuberculosis-free residents, but these variables were the predictors of malnutrition among TB patients. These indicate that TB patients are very susceptible to malnutrition even the very distal factor for malnutrition in the community became a proximal factor for TB patients.
The limitation of the study might be related to the cross sectional nature of the study which makes difficult to identify whether the exposure precedes the outcome However this limitation works only for modifiable variables thought time.