<![CDATA[Pediatric tuberculosis remains a critical global health challenge, with suboptimal treatment outcomes frequently mediated by concurrent malnutrition and inconsistent medication compliance. The present study systematically investigated the association between anti-tuberculosis medication adherence and nutritional recovery among children diagnosed with pulmonary tuberculosis. An analytic cross-sectional design was employed, enrolling 106 pediatric patients selected via stratified random sampling from high-burden primary healthcare facilities. Medication adherence was quantified using standardized compliance metrics, while nutritional status was classified according to age-stratified anthropometric indices. Bivariate relationships were rigorously evaluated using Kendall’s tau-b. Results demonstrated a statistically significant, moderate positive association between adherence and nutritional status (r = 0.415, p < 0.001). The majority of participants (61.3%) exhibited high adherence, with 82.1% situated in the continuation phase of therapy (months 3–6). During this period, 88.7% of children attained optimal nutritional classification, wherein higher compliance consistently correlated with favorable anthropometric trajectories. Collectively, these findings robustly confirm that sustained adherence to antitubercular regimens is significantly associated with enhanced nutritional recovery in pediatric pulmonary TB. Consequently, integrating structured adherence counseling, caregiver empowerment, and routine nutritional screening into standardized clinical pathways is imperative to optimize therapeutic efficacy, accelerate somatic growth, and mitigate long-term developmental sequelae in vulnerable pediatric populations in resource-constrained settings.]]>
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