Allium sativum L. Extract Encapsulated with Chitosan Nanoparticle in the Nutritional Management of Multidrug-Resistant Tuberculosis (MDR-TB): A Comprehensive Literature Review about Strategy in Traditional Herbal Plants

Multidrug-resistant tuberculosis (MDR-TB) remains a major global health challenge, characterized by prolonged treatment, poor clinical outcomes, and high mortality rates. One of the most critical yet often overlooked factors contributing to poor prognosis in MDR-TB is malnutrition, which weakens immune function, delays sputum conversion, and increases the risk of treatment failure. Undernutrition in TB is multifactorial, driven by reduced appetite, chronic inflammation, metabolic alterations, and micronutrient deficiencies. This comprehensive literature review aims to explore the potential role of Allium sativum L. extracts encapsulated in chitosan nanoparticles as an innovative adjunctive strategy in the nutritional management of MDR-TB. The review emphasizes the dual benefits of this approach: enhancing antimicrobial efficacy while simultaneously addressing the nutritional deficits that compromise immune competence in MDR-TB patients. The review covers (1) the pathophysiological links between malnutrition and MDR-TB; (2) the antimicrobial, immunomodulatory, and metabolic effects of garlic bio-actives such as allicin, ajoene, and organosulfur compounds; (3) the role of cholesterol metabolism and host immune-nutritional status in TB outcomes; and (4) the advantages of nanoparticle-based delivery systems, particularly chitosan, in improving the stability, bioavailability, and targeted delivery of garlic compounds. Integrating garlic extracts within chitosan nanoparticle carriers provides a promising dual-function intervention that not only helps reduce the mycobacterial burden, but also supports nutritional recovery in malnourished MDR-TB patients. Future clinical studies are essential to validate these findings and translate them into practical applications in MDR-TB care.