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ICMR study shows improved nutrition's impact in curbing TB; WHO agrees
The aim of the study was to determine the effect of nutritional supplementation on tuberculosis incidence in household contacts of adults with microbiologically confirmed pulmonary tuberculosis.
Household contacts of 2,800 patients with microbiologically confirmed pulmonary tuberculosis across 28 units of the National Tuberculosis Elimination Programme in four districts of Jharkhand were enrolled for this field-based, open-label, cluster-randomised controlled trial.
The study, published by The Lancet, said that in India, tuberculosis and undernutrition are syndemic, with a high burden of TB coexisting with a high burden of undernutrition in patients and in the population.
In a post on X on August 7, ICMR said the WHO has recognised this research and incorporated its findings into updated global guidance on TB control.
During the study, although microbiologically confirmed pulmonary tuberculosis patients in both groups received food rations for six months, only household contacts in the intervention group received monthly food rations and micronutrients.
After screening all household contacts for co-prevalent tuberculosis at baseline, all participants were followed up actively until July 31, 2022, for the primary outcome of incident tuberculosis, the study said.
Between August 16, 2019, and January 31, 2021, there were 10,345 household contacts, of whom 5,328 (94.8 per cent) of 5,621 household contacts in the intervention group and 4,283 (90.7 per cent) of 4,724 household contacts in the control group completed the primary outcome assessment.
Almost two-thirds of the population belonged to indigenous communities such as Santhals, Ho, Munda, Oraon, and Bhumij) and 34 per cent suffered from undernutrition.
"To our knowledge, this is the first randomised trial looking at the effect of nutritional support on tuberculosis incidence in household contacts, whereby the nutritional intervention was associated with a substantial reduction in tuberculosis incidence in the household during 2 years of follow-up.
"This biosocial intervention can accelerate reduction in tuberculosis incidence in countries or communities with a tuberculosis and undernutrition syndemic," the study said.
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