Why India needs to pay attention to the nutritional needs of TB patients

Here's why tuberculosis and malnutrition go hand-in-hand,

By: Pavitra Sampath | | Updated: March 23, 2015 1:10 pm

Tags: Malnutrition TB World Tuberculosis Day

The World Health Organisation estimates that every year over 2 million new cases occur in India, which has 24 percent of the total cases of tuberculosis the world over. Also Read - World Tuberculosis Day 2020: TB tests you need to know about

Also Read - World Tuberculosis Day: Does TB increase your risk of coronavirus?

Sounds shocking right? Well, it is time we took notice of this disease and addressed the reasons for our failure to control its spread. One of the most common and extremely rectifiable causes is malnutrition. Also Read - World Tuberculosis Day 2020: Dos and don’ts if you have TB

Malnutrition is a major public health problem in India. India has 42 percent of the world s underweight children and a third of the women in the reproductive age group are under-nourished with BMI below the cut-off level of 18. Malnutrition is where there is an energy-calorie deficit, resulting in either stunted growth (where a person does not grow in accordance to the standard age) or wasting (low weight for height) in children and low body mass index (BMI) in adults. You may also like to read about the 10 shocking facts about tuberculosis.

Why is malnutrition a risk factor and consequence of tuberculosis?

Tuberculosis and malnutrition go hand in hand. While malnutrition can put a person at risk for tuberculosis, especially, the lack of proteins, vitamins and minerals, tuberculosis itself can cause malnutrition.
This is mainly because untreated tuberculosis causes wasting away of the body, due to the immense energy your body needs to fight the disease. Apart from that, tuberculosis is also known to cause a reduction in appetite, thereby leading to malnutrition, which in turn increases the risk of progression of the ailment.
Tuberculosis patients, who are malnourished, have delayed recovery and higher mortality rates than well-nourished subjects.
Low BMI and lack of adequate weight gain with treatment are associated with increased risk of death and relapse.

How can proper nutrition help in recovery from tuberculosis

Food and nutrition support breaks the vicious cycle of malnutrition-tuberculosis nexus through several mechanisms. Here’s how:

Good nutrition helps keep the immune system strong, which in turn helps fight the infection better.
Nutrition support can help increase case detection, better treatment uptake and greater treatment adherence.

Why is providing nutritional substitution the key to beating this disease?

Nutritional supplementation appears to be an important adjunct to improve outcome in tuberculosis patients. In that regard, both provision of nutrition supplements and nutrition counselling are important. There is a strong argument to provide food supplements to persons diagnosed with tuberculosis and who are undergoing DOTs therapy. Nutrition supplements and nutrition counselling will have multiple benefits.

Moreover, poverty is an underlying cause in many with tuberculosis and malnutrition. The disease further aggravates these conditions by keeping the affected individuals from productive work and further pushing them into financial hardship. This in turn forces a patient to resume work without continuing their medication — further worsening his/her condition. You may also like to read more about way to prevent TB.

Providing nutritional supplements as a part of the DOTs treatment plan will help in the following ways:

It will help many subjects with tuberculosis return to productive work much faster.
When nutrition supplementation is started during the initial phase of tuberculosis treatment, it results in significant increase in body weight and better response to treatment.
The convalescent period is also shortened and helps earlier return to productive work.
Vitamins and minerals play an important role in treatment of tuberculosis and any supplement provided has to be fortified with essential vitamins and minerals.

Therefore. it is highly relevant in the Indian situation, that nutritional support be recommended as a part of treatment of tuberculosis as this could confer socioeconomic and survival benefits.

India has been in the forefront of providing food security to its population and the National Food Security Act is a case in point. Given the magnitude of the morbidity and mortality associated with tuberculosis, the link between food insecurity, malnutrition and tuberculosis, there is a strong case in India to provide fortified food supplements to those on anti-tubercular therapy. This will help increase case detection, treatment adherence and response. Hope nutrition supplementation as an adjunct therapy in management of tuberculosis becomes a reality in India as this will help in our fight against the deadly scourge of tuberculosis.

With inputs from Dr Rajan Sankar , country manager, India and Senior advisor, South Asia, GAIN. Dr Rajan joined GAIN in 2006 as responsible for supporting GAIN s program development and grant, management in India. He is a medical graduate from the University of Madras with a specialisation in internal medicine and endocrinology. Prior to joining GAIN, Dr. Sankar was a project officer in the Child Development and Nutrition section of UNICEF in India. In 2001, he retired as Colonel from the Indian Army Medical Corps after 24 years of service. He has published more than 50 scientific papers in national and international journals.

Image source: Shutter Stock

Published : March 23, 2015 1:05 pm | Updated:March 23, 2015 1:10 pm

Read Disclaimer