The findings, she said, add to the evidence supporting policies that include nutrition as an intervention to prevent new TB cases at a time when the number of new cases is not reducing as quickly as it needs to for India to eliminate TB by 2025.
According to Anurag Bhargava and Madhavi Bhargava of Yenepoya University near Mangalore, as well as their collaborators at the National Institute for Research in Tuberculosis in Chennai and other institutions, the food basket would cost Rs 325 per household contact per month, including delivery, at 2019 prices.
“We expect that the food basket will not only lower the risk of TB infections among the household contacts but also protect them from other infections by raising general nutrition levels,” Anurag Bhargava said.
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Since April 2018, the Narendra Modi government, which established the 2025 elimination target, has provided nutritional support to TB patients in the form of a monthly payment of Rs 500 during treatment, which normally lasts six months in uncomplicated TB.
Nikshay Mitra Initiative: Extending Nutritional Support Beyond the Patient
Last year, the Union Health Ministry also launched a crowd-sourced system called Nikshay Mitra, which allows individuals, corporate organizations, and other entities to provide nutritional support to tuberculosis patients. “If nutritional support were to be extended to the families of TB patients, it could potentially drive down TB cases in the community,” said Swaminathan, who was a member of the team that conducted the Jharkhand study.
Chasing the TB Elimination Target
A health ministry assessment issued earlier this year anticipated that TB incidence (new cases) in 2022 would be 196 per 100,000 people, far exceeding the elimination plan’s objective of 77 by 2023 and 44 by 2025 (1).
The Bhargavas and their collaborators followed 10,345 household contacts of 2,800 TB patients in four Jharkhand districts – Ranchi, Seraikela Kharsawan, East Singhbhum, and West Singhbhum – for three years.
They documented 218 new TB cases among the contacts. “But our study suggests a 48% reduction in new lung TB cases over the three years in households that got the food baskets,” said Madhavi Bhargava. The study was published The Lancet.
Nutrition as Medicine: The Protective Power of a Meal Basket
While family contacts at high risk of contracting tuberculosis may also be offered anti-TB drugs, the researchers found that a meal basket containing rice, lentils, and multivitamins provided comparable protection.
Every month, each of the 2,800 TB patients received 5kg rice, 1.5kg milk powder, 3kg roasted chickpea flour, 500 ml oil, and multivitamins. The study found a lower risk of death with weight gain, as expected. A 5% weight gain after two months of treatment lowered the risk of mortality by 60%.
The death rate among TB patients was 3.9%, which was much lower than the 6% death rate seen among TB patients from six states who received no nutritional care.
References:
- https:tbcindia.gov.in/WriteReadData/l892s/5646719104TB%20AR-2023_23-%2003-2023_LRP.pdf
Source: Medindia
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