Anemia in Tuberculosis Patients


  • Inna Kurniaji Medical Faculty, Lampung University
  • Waluyo Rudiyanto
  • Indri Windarti



Anemia, TB patients, tuberculosis


Tuberculosis (TB) is one of the most common causes of health problems in the world. The prevalence of TB in the world is estimated at 10.6 million, and 1.6 million of them died from TB, in Indonesia the incidence of TB reached 503,712. Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis, which is known to cause complex hematological disorders. The hematopoietic system is thought to be affected during TB infection, so that Hb levels tend to decrease along with bacterial increase, which eventually causes anemia. The article aims to determine the incidence of anemia in TB patients and the mechanism of anemia in TB patients. Based on the results of a literature review conducted on references found from 2012–2022, it shows that anemia is a common condition in TB. The mechanism that causes anemia in TB patients is due to its pathogenesis as a chronic inflammatory disease. Anemia is an indicator in providing clues to diagnosis, prognosis, complications and response to TB therapy. Nutritional intake and adherence to TB therapy need to be done properly to prevent the development of severe disease and improve the patient's quality of life.

Author Biographies

Waluyo Rudiyanto



Indri Windarti




WHO. Tuberculosis. World Health Organisation (WHO). Published 2022.

Kemenkes RI. Strategi Nasional Penanggulangan Tuberkulosis Di Indonesia 2020-2024. Kementerian Kesehatan RI; 2020.

Kemenkes RI. Pedoman Nasional Pelayanan Kedokteran Tatalaksana Tuberkulosis. Kementerian Kesehatan RI; 2020.

Sharma SK, Mohan A. Tuberculosis: From an incurable scourge to a curable disease - Journey over a millennium. Indian J Med Res. 2013;137(3):455-493.

Abay F, Yalew A, Shibabaw A, Enawgaw B. Hematological Abnormalities of Pulmonary Tuberculosis Patients with and without HIV at the University of Gondar Hospital, Northwest Ethiopia: A Comparative Cross-Sectional Study. Tuberc Res Treat. 2018;2018:1-6. doi:10.1155/2018/5740951

Adzani M, Dalimoenthe NZ, Wijaya I. Profile of Anemia on Lung Tuberculosis at Dr. Hasan Sadikin General Hospital and Community Lung Health Center Bandung. Althea Med J. 2016;3(1):137-140.

Ujiani S, Nuraini S. Pengaruh Infeksi Mycobacterium tuberculosis Terhadap Parameter Hematologi Anemia dan Malnutrisi Pasien TB di Puskesmas Bandar Lampung Effects of Mycobacterium tuberculosis Infection on Hematologic Parameters of Anemia and Malnutrition in TB Patients at Ba. J Anal Kesehat. 2020;9(1):1-8.

de Mendonça EB, Schmaltz CAS, Sant’Anna FM, et al. Anemia in tuberculosis cases: A biomarker of severity? PLoS One. 2021;16(2 February):1-12. doi:10.1371/journal.pone.0245458

Kashyap A, Bhagat M, Mahajan R. Anemia and Nutritional Status in Tuberculosis Patients. Int J Appl Basic Med Res. 2021;11(4):226-230. doi:10.4103/ijabmr.ijabmr

Sylvia P, Lorraine W. Patofisiologi Konsep Klinis Proses-Proses. 6th ed. EGC

WHO. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. World Health Organization; 2013. doi:2011

Kiswari R. Hematologi Dan Transfusi. 1st ed. Penerbit Erlangga; 2014.

Nandennavar M, Cyriac S. Immune Hemolytic Anemia in a Patient with Tuberculous Lymphadenitis. 2013;(1):89-91. doi:10.4103/0974-777X.77303

Dorhoi A, Kaufmann SHE. Pathology and immune reactivity : understanding multidimensionality in pulmonary tuberculosis. Published online 2015. doi:10.1007/s00281-015-0531-3

Ganz T, Nemeth E. Hepcidin and Iron Homeostasis. NIH. 2014;1823(9):1434-1443. doi:10.1016/j.bbamcr.2012.01.014.HEPCIDIN

Edmondson N, Cronje L, Eisenach KD, Bornman L. Iron and iron chelating agents modulate Mycobacterium tuberculosis growth and monocyte-macrophage viability and effector functions. FEMS Immunol Med Microbiol. 2013;45(2005):103-112. doi:10.1016/j.femsim.2005.02.007

Gil-Santana L, Cruz LAB, Arriaga MB, et al. Tuberculosis-associated anemia is linked to a distinct inflammatory profile that persists after initiation of antitubercular therapy. Sci Rep. 2019;9(1):1-8. doi:10.1038/s41598-018-37860-5

Sahiratmadja E, Wieringa FT, van Crevel R, et al. Iron deficiency and NRAMP1 polymorphisms (INT4, D543N and 3′UTR) do not contribute to severity of anaemia in tuberculosis in the Indonesian population. Br J Nutr. 2013;98(4):684-690. doi:10.1017/S0007114507742691

Dasaradhan T, Koneti J, Kalluru R, Gadde S. Tuberculosis-Associated Anemia : A Narrative Review. 2022;14(8). doi:10.7759/cureus.27746

Mulenga CM, Kayembe JN, Kabengele BO. Anemia and Hematologic Characteristics in Newly Diagnosed Pulmonary Tuberculosis Patients at Diagnosis in Kinshasa. Published online 2017:243-257. doi:10.4236/jtr.2017.54026

Minchella PA, Donkor S, Owolabi O, Sutherland JS, Mcdermid JM. Complex Anemia in Tuberculosis : The Need to Consider Causes and Timing When Designing Interventions. 2015;60:764-772. doi:10.1093/cid/ciu945



How to Cite

Kurniaji, I., Rudiyanto, W., & Windarti, I. (2023). Anemia in Tuberculosis Patients. Medical Profession Journal of Lampung, 13(1), 42-46.




Most read articles by the same author(s)