The high anemia prevalence in PWTB could stems from multiple factors: increased metabolic demand exacerbating iron deficiency [10], chronic inflammation elevating hepcidin (which impairs iron absorption and recycling) [45], comorbidities (parasitic infections) depleting nutrients [46], and reduced dietary intake due to TB-associated anorexia and gastrointestinal disturbances [47]. This evidence concerns the gene HAMP and parasitic infectious disease.