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In a breakthrough finding, a study published in The Lancet Global Health journal has revealed that providing nutritional support to half the households with individuals undergoing tuberculosis (TB) treatment in India could significantly reduce TB-related deaths and cases by 2035. This intervention could avert over 3.6 lakh deaths and 8.8 lakh TB cases, marking a pivotal step toward combating the disease in one of the world’s most TB-burdened nations.
Key Findings and Projections
The study, conducted by researchers from the Indian Council of Medical Research (ICMR)-National Institute for Research in Tuberculosis (NIRT), Chennai, utilized data from a 2023 clinical trial to model the impact and costs of nutritional support. The projections suggest that providing nutritional assistance to 50% of affected households could prevent approximately 4.5% of TB-related deaths and 2.2% of TB episodes.
On average, 24 households would need to receive nutritional support to prevent one death, and 10 households to avert one TB case. The intervention is estimated to cost an additional US $1,349 million for the health system, delivering a potential return of US $167 per disability-adjusted life-year (DALY) averted.
Undernutrition: A Critical Factor in TB Burden
Undernutrition is a major contributor to TB incidence worldwide, accounting for one-fifth of cases globally and more than a third in India. The proposed nutritional intervention targets this critical risk factor by offering food rations to TB patients and their household contacts.
In the 2023 study, households received monthly food rations providing 1,200 kilocalories (52 grams of protein) for TB patients and 750 kilocalories (23 grams of protein) for their contacts over six months. This intervention led to a 39-48% reduction in TB incidence within households during a two-year follow-up period.
Implications for Public Health and Economy
India has long been at the forefront of the global fight against TB, accounting for the largest share of the disease burden. The study highlights that a national focus on nutritional support, particularly in states with high levels of undernutrition, could deliver substantial health and economic benefits.
Moreover, a recent study published in PLoS Medicine estimated that improving case detection rates and achieving the World Health Organization’s (WHO) End-TB target of 90% could cut disease incidence by 75-90%, reducing the macroeconomic burden by USD 120.2 billion by 2040.
Call to Action
The authors of the Lancet study emphasized that their findings likely underestimate the broader health and cost-effectiveness benefits of nutritional support. The intervention could contribute significantly to India’s efforts to eliminate TB, aligning with the WHO’s End-TB strategy.
As TB continues to pose a significant public health challenge, the integration of nutritional support into India’s National Tuberculosis Elimination Programme could be a game-changer, saving lives and mitigating the socioeconomic impact of the disease.
