The Influence of Malnutrition, Diabetes Mellitus, and Helminth Infections on Biosignatures in Latent Tuberculosis in a South Indian Population

March 11, 2026 updated by: National Institute of Allergy and Infectious Diseases (NIAID)

A Cross-Sectional Study to Estimate the Influence of Malnutrition, Diabetes Mellitus and Helminth Infections on Biosignatures in Latent Tuberculosis in a South Indian Population

About 2 billion people worldwide are infected with tuberculosis (TB). Ninety percent of those people have latent TB infection (LTBI). Risk factors like malnutrition, diabetes mellitus (DM), and helminth infection can affect the development of active TB. Researchers want to study LTBI individuals with these issues to see how they may contribute to a person s higher risk for developing active TB. This study will take place in Chennai, India.

Objective:

To estimate the prevalence of malnutrition, DM, and helminth infections in people with LTBI.

Eligibility:

People age 14 65 with or without LTBI.

Design:

Participants will be screened with a medical history and physical exam focused on symptoms of active TB. Those who have TB symptoms will not take part in the study. Those who do not have TB symptoms will have a physical exam with vital signs, height, and weight. They will give blood and stool samples.

Participants will be assigned to 1 of 6 groups. They will repeat some of the screening tests. They will give urine samples. Some groups will have a chest X-ray. Some groups will have an ultrasound of the abdomen.

Participants will complete a survey about their history of smoking and drug and alcohol use.

Participants will have data collected about their nutritional status and body composition. Their skinfold thickness, ratio of waist/hip circumference, and grip strength will be measured.

Participants with DM, malnutrition, or helminth infection will be given standard of care or referred for follow-up treatment.

Participation will last up to 6 months.

...

Study Overview

Status

Completed

Conditions

Detailed Description

Approximately 2 billion people worldwide are infected with Mycobacterium tuberculosis (TB), with 90% of individuals having latent infection (LTBI). The control of TB requires clearly delineated helper T cell (Th) 1 responses and, to a lesser extent, Th17 responses, which both play important roles in the induction and maintenance of protective immune responses in mouse models of TB infection and in the prevention of active disease, as seen in LTBI. During latency, M. tuberculosis is contained in localized granulomas. Mycobacteria-specific T cells mediate delayed-type hypersensitivity reactions to purified protein derivative (PPD), and this reaction is generally considered to indicate an LTBI status in the absence of demonstrable active infection.

Among the various risk factors that are known to play a role in promoting active TB, HIV is the most well studied and described. However, in low-HIV-endemic countries like India, other risk factors might play a more prominent role in active TB pathogenesis. These include malnutrition, diabetes mellitus (DM), and helminth infections. LTBI individuals with these comorbidities or coinfections could be at a higher risk for developing active TB than their healthy LTBI counterparts without these comorbidities. Thus, it is imperative to study the pathogenesis of TB infection and disease in these at-risk populations.

In this study, we will estimate the prevalence of severe to moderate malnutrition, uncontrolled DM, and helminth infections in LTBI-positive individuals. We will collect samples from a cohort of individuals with LTBI, those with LTBI and coexistent malnutrition, DM, or helminth coinfection, and those without any of these conditions. Individual participation may last up to 6 months. The main objective of the study is to estimate the prevalence of malnutrition, DM, and helminth infections in LTBI individuals.

Simultaneously, we will perform transcriptomic, proteomic, and metabolomic assays, including profiles in serum and urine, to determine the biosignature portfolio of these individuals. In addition, immunological assays examining cytokine/chemokine signatures as well as other immune parameters related to innate and adaptive responses will be performed to enhance the understanding of the immunological cross-talk between LTBI and malnutrition, DM, and helminth infections.

Study Type

Observational

Enrollment (Actual)

626

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • India
      • Chennai, India
        • National Institute for Research In Tuberculosis, International Centers for Exel

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

10 years to 61 years (Child, Adult, Older Adult)

Accepts Healthy Volunteers

Yes

Sampling Method

Non-Probability Sample

Study Population

Participants will be recruited from villages in the Kancheepuram District in south India. The census in villages in the Kancheepuram District is updated annually by local health workers employed by the Department of Public Health and the field teams of the NIRT in Chennai, India. The villages will be chosen in consultation with the Department of Public Health in Tamil Nadu.

Description

  • PARTICIPANT INCLUSION CRITERIA (Screening Phase)

Individuals who meet the following criteria are eligible to participate in the screening phase:

  • Aged 14 to 65 years.
  • Willingness to provide blood, urine, and stool samples for examination.
  • Willingness to have samples and data stored.
  • Able to provide informed consent.

PARTICIPANT EXCLUSION CRITERIA (Screening Phase)

  • Pulmonary symptoms suggestive of TB (cough >2 weeks in duration and/or intermittent fever >1 week in duration and/or hemoptysis).
  • Two IGRA tests with indeterminate results (mitogen values <10 IU).

PARTICIPANT INCLUSION CRITERIA (Study Phase)

Individuals are eligible for the study phase if they meet the requirements for one of the study groups, as follows:

  1. LTBI+ and severe to moderate malnutrition (BMI <17 kg/m2);
  2. LTBI+ and uncontrolled DM (HbA1c >8%);
  3. LTBI+ and helminth infection (positive stool qPCR and/or serology);
  4. LTBI+ with more than one of the conditions defined in groups 1 3;
  5. healthy LTBI+ controls who are negative for all of the above conditions; and
  6. healthy LTBI-negative controls with none of the above conditions.

PARTICIPANT EXCLUSION CRITERIA (Study Phase)

  • Pulmonary symptoms suggestive of TB (cough >2 weeks in duration and/or intermittent fever >1 week in duration and/or hemoptysis).
  • Pregnant or lactating women.
  • Previous treatment for LTBI.
  • Anemia with hemoglobin <8 g/dl (evaluated at the screening phase visit).
  • For LTBI+ participants, clinically indicated chest X-ray positive for pulmonary TB.
  • For malnourished participants, clinically indicated abdominal ultrasound positive for abdominal TB.
  • Known documented cases of cancer, acquired immune deficiency syndrome, or other immunosuppressive illness.
  • History of any other illness or condition which, in the investigator s judgment, may substantially increase the risk associated with the participant s participation in the protocol, or compromise the scientific objectives.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Cohort
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
'healthy' LTBI+ controls who are negative for all of the conditions
'healthy' LTBI+ controls who are negative for all of the listed conditions
healthy LTBI negative controls with none of the above conditio
healthy LTBI negative controls with none of the above conditions
LTBI+ and helminth infection (positive stool qPCR and/or serol
LTBI+ and helminth infection (positive stool qPCR and/or serology)
LTBI+ and severe to moderate malnutrition (BMI <17 kg/m2)
LTBI+ and uncontrolled DM (HbA1c >8%)
LTBI+ with more than one of the conditions defined in groups 1
LTBI+ with more than one of the conditions defined in groups 1-3

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Prevalence of malnutrition, DM and helminth infections in LTBI individuals and their effects on biosignatures
Time Frame: Study Phase visit
Prevalence of malnutrition, DM and helminth infections in LTBI individuals and their effects on biosignatures
Study Phase visit

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Institute of Allergy and Infectious Diseases (NIAID)

Investigators

  • Principal Investigator: Thomas B Nutman, M.D., National Institute of Allergy and Infectious Diseases (NIAID)

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 19, 2021

Primary Completion (Actual)

March 11, 2026

Study Completion (Actual)

March 11, 2026

Study Registration Dates

First Submitted

August 25, 2020

First Submitted That Met QC Criteria

August 25, 2020

First Posted (Actual)

August 26, 2020

Study Record Updates

Last Update Posted (Actual)

March 12, 2026

Last Update Submitted That Met QC Criteria

March 11, 2026

Last Verified

March 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 999920144
  • 20-I-N144

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

This is a sample/data collection study to estimate the prevalence of malnutrition. DM and helminth infections in LBTI subjects. There is no plan to share individual participant data

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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