India faces challenge with tuberculosis (TB). Despite progress in reducing cases and deaths, the country still has the highest TB burden globally. Recent research indicates that nutrition could play a very important role in controlling this epidemic.
Current TB Situation in India
In 2024, India reported 2.6 million TB cases. This was a slight decrease from 2.55 million cases in 2023. The National Tuberculosis Elimination Programme (NTEP) has contributed to a decline in TB incidence rates. From 2015 to 2023, the incidence rate fell from 237 to 195 cases per million people. TB-related deaths also decreased from 28 to 22 per million in the same period.
The Impact of Nutrition on TB
Recent findings suggest that improving nutrition could reduce TB cases and deaths. Research published in The Lancet Global Health indicates that providing food support and vitamin supplements to TB patients and their families could prevent approximately 880,700 cases and 361,200 deaths by 2035. This intervention would cost around $1.3 billion and is deemed highly cost-effective.
RATIONS Trial Findings
The RATIONS trial conducted in Jharkhand demonstrated that better nutrition improved treatment outcomes. Patients and their families experienced fewer new TB infections when given nutritional support. Undernutrition is a major driver of TB in India, responsible for over a third of new cases.
Drug Resistance Challenges
Despite advances, drug resistance poses a growing threat. A study published in Clinical Infectious Diseases revealed that over one-third of patients treated with bedaquiline developed resistance. Among 117 patients in Delhi and Mumbai, 42 showed resistance. Nearly 90% of these patients had poor treatment outcomes, with mortality rates.
Implications for Public Health Policy
These findings underline the need for integrating nutrition into TB care. Decision-makers are encouraged to advocate for targeted interventions that address the nutritional needs of TB patients. Without addressing undernutrition, efforts to combat TB may be undermined.
Future Directions
As India scales up newer all-oral drug regimens, timely drug-susceptibility testing becomes crucial. This will help prevent the spread of resistant strains and improve treatment outcomes. The intersection of nutrition and TB care presents a unique opportunity for public health advancement.
Questions for UPSC:
- Critically discuss the role of nutrition in public health interventions for infectious diseases.
- Analyse the impact of drug resistance on tuberculosis treatment outcomes in India.
- Estimate the economic implications of integrating nutritional support in tuberculosis care.
- Examine the relationship between undernutrition and the prevalence of infectious diseases in developing countries.