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United News of India
5 days ago
- Health
- United News of India
WHO hails Indian study on nutrition's role in TB as global guideline
New Delhi, Aug 6 (UNI) A study conducted by India that demonstrated the positive impact of nutrition on tuberculosis (TB) outcomes has drawn the attention of the World Health Organisation (WHO) which has described it 'as a global guidance on combating the world's most infectious disease.' Led by the Indian Council of Medical Research (ICMR), the study — conducted in Jharkhand — provided the first evidence that offering additional nutrition helps prevent TB cases and reduces mortality in India. 'The findings from India's RATIONS study on the impact of nutrition on TB outcomes and incidence have contributed to global guidance,' the WHO said during a three-day virtual workshop. The study, 'Nutritional support for adult patients with microbiologically confirmed pulmonary tuberculosis: outcomes in a programmatic cohort nested within the RATIONS trial in Jharkhand, India' is published in The Lancet Global Health in 2023. The researchers of the study had provided nutritional support to a cohort with a high prevalence of severe undernutrition in the State. The results were encouraging. 'Weight gain, particularly in the first 2 months, was associated with a substantially decreased hazard of tuberculosis mortality. Nutritional support needs to be an integral component of patient-centred care to improve treatment outcomes in such settings,' said the study. Asserting the member nations to share such innovative practices, the WHO has urged the South-East Asia Region — which accounts for the highest share of TB cases and deaths globally — to also urgently scale up research and innovation to meet End TB goals. 'In our region alone, nearly 5 million people developed TB and close to 600,000 died from the disease in 2023,' said Dr. Catharina Boehme, Officer-in-Charge, WHO South-East Asia Region in a statement here. She further added, 'Achieving the ambitious targets of the WHO End TB Strategy requires collaboration to accelerate research and innovation. This includes adopting and using new tools, technologies, and drugs. Ensuring timely and equitable access to these innovations is critical to achieving impact at scale, leaving no one behind.' The WHO noted that the South-East Asia Region has made notable progress, including a rise in TB case notifications in 2023 — a sign of recovery following COVID-19-related setbacks, however, progress remains insufficient to meet End TB Strategy targets. Following the pandemic, noted the WHO, as per the statement, TB has re-emerged as the world's leading cause of death from a single infectious agent. The disease disproportionately affects the poorest and most vulnerable, deepening existing inequalities. To counter this, 'countries in the region are increasingly leveraging new approaches such as artificial intelligence for case detection, computer-aided diagnostics, digital adherence tools, and direct benefit transfers for patients to streamline social support,' the WHO said. 'Our progress is uneven. Research and innovation capacity varies across the region, and the results of these efforts are often siloed and inaccessible for collaborative use. The rise in drug-resistant TB remains very concerning,' said Boehme. UNI AJ SSP
The Hindu
11-07-2025
- Health
- The Hindu
Undertaking TB death audits like the maternal mortality model can aid TB elimination goals: Soumya Swaminathan
A detailed dissection of every tuberculosis-related death at the district level or a 'TB death audit,' much like the public health approach adopted by the Centre to reduce maternal deaths, will prove to be useful towards meeting India's TB elimination goals, Soumya Swaminathan, Principal Advisor for the National TB Elimination Programme in India told The Hindu. 'Like COVID, TB is also a pandemic, but it has been around for a very long time. It affects the poor and vulnerable in every country. Even one dengue death gets picked up immediately by the media and gets reported. Still, 800 to 900 people die every day of TB in the country, but the news of a TB death hardly ever makes it to the newspaper,' she said. Challenges facing NTEP Dr. Swaminathan noted that among the challenges facing the National TB Elimination Programme (NTEP) is the further reduction in TB mortality rates to meet the End TB and Sustainable Development Goals (SDG) targets. From an estimated 35 deaths per 1,00,000 population in 2015, India has brought down this rate to 22 per 1,00,000 according to the latest official data. 'However, we still have case fatality rates ranging from 5% to 10% in different states. These rates are higher for drug-resistant TB. These deaths are mostly happening in the economically-productive age group of 25 to 55 years,' she said. TB Death Audit India has significantly reduced its maternal mortality rate (MMR) by expanding the scope for institutional delivery, better antenatal and postnatal care and by undertaking district-wise maternal death audits, which are headed by the district collectors. 'Everyone has to sit and explain why that (maternal) death happened and how it could have been prevented. Can we adopt a similar approach for TB?,' asks Dr. Swaminathan. 'The district collector should be aware of how many TB deaths occur, and non-programme partners should be engaged in audits of randomly selected cases. These could be community medicine departments of nearby medical colleges or public health institutes. It should not be the TB programme itself that does the death audits. TB deaths should be presented, analysed along with reasons, and the discussions could lead to improvements in service delivery,' she added. The deaths are most likely caused by a combination of complications due to TB, along with social and economic risk factors. Citing an example, Dr. Swaminathan says that the National Institute of TB and Respiratory Diseases runs a 'difficult to treat' virtual TB clinic (using the ECHO platform), where cases are presented and discussed every month, for the benefit of doctors and nurses across the country. The case of a 19-year-old belonging to a poor migrant family who succumbed to TB in Delhi was presented. Her father had previously died of TB and her sister had also contracted the infection. 'They worked as housemaids and had initially sought treatment with private doctors. By the time she got admitted, she had extensive bilateral TB and was in respiratory failure. The fact that a 19-year-old girl died of drug sensitive TB points to the need for every patient to be notified and followed up by the TB programme. Any number of such cases are occurring every day. Are we paying attention and trying to improve the system?' Tamil Nadu model for reducing TB deaths Tamil Nadu's Kasanoi Erappila Thittam (TN-KET) meaning 'TB death free project,' was jointly started by the Indian Council of Medical Research's National Institute of Epidemiology (NIE) and the State government for all aged 15 years and older with drug-susceptible TB notified by public facilities, with a goal to reduce deaths by 30% in this group. According to NIE data, during April - June 2022, 14,961 TB patients were notified out of which 11599 (78%) were triaged. It was found that of these 1509 (13%) were at high risk of severe illness. Of these 48% were severely undernourished, another 50% had respiratory insufficiency, and 29% were unable to stand without support. Of the 1509 patients, 1128 (75%) were assessed at a nodal inpatient care facility. Of these, 993 were confirmed as severely ill, and 909 (92%) were admitted. Of those admitted 4% patients succumbed to their illness. As a result of implementing TN-KET, Tamil Nadu now routinely captures BMI data for all adults with TB (notified from public facilities). In the southern States, people have co-morbidities such as diabetes, alcoholism and in the north, there is severe malnutrition and severe anaemia, Dr. Swaminathan observed. In any case, every TB patient must be clinically evaluated for co-morbidities and risk factors and these should be treated too. Dr. Swaminathan pressed on the need to prioritise reducing TB deaths, along with reducing prevalence, and incidence of the disease. 'China has a death rate of 3 per 1,00,000 from TB, while India has a death rate of 22 per 1,00,000. We need to find gaps, address them and have an ambitious plan,' she said. 'Our short-term focus, in the next National Strategic Plan is to reduce TB mortality. Incidence reduction will take time, whatever we do, because we don't have a highly efficacious vaccine. Unless we start finding everyone and treating them, we will not have a rapid incidence reduction.' Need for widespread screening Dr Swaminathan said that the National TB prevalence Survey and State-specific Prevalence Surveys in Gujarat, Rajasthan reveal that sub-clinical TB accounts for 40% to 50% of cases. 'Which means, you will not pick them up with symptom screening and our national programme was entirely based on symptom screening. So, we were straightaway missing half of the active TB in population,' she said. According to her, the solution is to have widespread use of X-ray backed up by an AI algorithm. 'The hand-held X-ray technology with AI is green-lighted by the World Health Organization (WHO), STOP TB Partnership and ICMR. In fact, six government hospitals in Mumbai applied X-ray screening and their case notifications went up by 10% to 12%,' she stated. Upfront molecular testing until last year in India was 30%. The 100-day TB elimination campaign aimed at strengthening diagnostics and linkage to treatment, as well as efforts by CTD to expand upfront molecular testing, should pay dividends this year, she added. Upfront molecular testing involves offering tests which can pick up TB as well as drug-resistance to TB bacteria leading to accurate treatment, which improves chances of the patient's recovery. Screening of household contacts should be made convenient, as they cannot be expected to spend days in going and getting themselves screened. This can happen now with the highly portable handheld X-ray devices, which many States have started using. The crucial role of nutrition She also emphasised on providing good nutrition to TB patients and their families. 'The RATIONS trials led by Anurag Bhargava in Jharkhand among a population with BMI as low as 16 and 17 has demonstrated that almost 50% secondary household cases could be prevented just by providing good nutritional support. We don't yet have a vaccine with 50% efficacy, so if we give adequate calories and protein, it acts like natural protector from bacteria.' Commenting on the Nikshay Mitra Programme floated by the Centre for nutrition support to TB patients, Dr. Swaminathan said that while the goal was laudable, its success depends on volunteers coming forward to donate nutrition support and this may not be uniform across all geographies. 'Also, the ability to deliver it (nutritional support) may be limited in remote areas,' she emphasised. The government's move to double the amount meted out under the Direct Benefit Transfer (DBT) - (an earlier amount of Rs. 500 per month provided to TB patients during treatment, has now been increased to Rs. 1000) would go a long way towards meeting the patients nutritional needs, and more research is needed in ways to improve the family's nutritional status, wherever needed.
The Citizen
15-05-2025
- Health
- The Citizen
Top 10 stories of the day: Cornal Hendricks remembered
Here's your daily news update for Thursday, 15 May 2025: An easy-to-read selection of our top stories. In the news today, the Bulls and Roses United Rugby Club have paid tribute to former Springbok winger Cornal Hendricks, who tragically passed away at the age of 37 on Wednesday. Meanwhile, Health Minister Dr Aaron Motsoaledi says more than 8 000 healthcare workers in South Africa lost their jobs following the withdrawal of United States (US) funding for HIV/Aids programmes. Furthermore, Minister in the Presidency Khumbudzo Ntshavheni has denied suggestions US President Donald Trump may attempt to make a fool of South Africa when he meets a delegation from our country next week. Weather tomorrow: 16 May 2025 Fire warnings are in place for Beaufort West and Laingsburg, with heat wave conditions expected in Richtersveld, Northern Cape. Full weather forecast here. Stay up to date with The Citizen – More News, Your Way. 'An infectious smile that brightened our world': Tributes pour in for Cornal Hendricks The Bulls and Roses United Rugby Club have paid tribute to former Springbok winger Cornal Hendricks, who tragically passed away at the age of 37 on Wednesday, in his home town of Wellington, reportedly due to a heart attack. Bulls chief executive Edgar Rathbone said Hendricks was a special player who will be dearly missed. Formers Springbok and Bulls wing Cornal Hendricks. Picture: Gareth Everett/Gallo Images 'He knew how to deliver just about the right dose of energy to help lift a room. He was an iconic teammate, a friend for many seasons, and an inspirational figure in the locker room,' Rathbone said. CONTINUE READING: 'An infectious smile that brightened our world': Tributes pour in for Cornal Hendricks Over 8 000 SA healthcare jobs lost – and more could follow – after US Pepfar aid cuts More than 8 000 healthcare workers in South Africa lost their jobs following the withdrawal of United States (US) funding for HIV/Aids programmes, Health Minister Dr Aaron Motsoaledi confirmed on Thursday. During a media update, Motsoaledi addressed the impact of the funding cuts while countering claims that the country's HIV response has collapsed. Minister of Health Aaron Motsoaledi before his keynote address at Sandton Hotel in Johannesburg, 19 March 2025, on the need to prioritise TB during the 'End TB media workshop'. Picture: Nigel Sibanda/The Citizen Despite the significant job losses, the health minister emphasised that the vast majority of the HIV/Aids workforce remains intact and operational across affected districts. 'In these 27 districts, there were 271 606 people who are working on the HIV/Aids programmes every day. 15 539 of these were funded by Pepfar , of which, yes, we can confirm today, unfortunately, 8 061 are out of their jobs,' Motsoaledi stated. CONTINUE READING: Over 8 000 SA healthcare jobs lost – and more could follow – after US Pepfar aid cuts Will Trump embarrass SA at White House meeting? Minister in the Presidency Khumbudzo Ntshavheni has denied suggestions US President Donald Trump may attempt to make a fool of South Africa when he meets a delegation from our country next week. On Wednesday, the Presidency confirmed that President Cyril Ramaphosa would embark on a working visit to the USA from 19 to 22 May 2025. Minister in the Presidency, Khumbudzo Ntshavheni. Picture: GCIS Ramaphosa will meet with President Donald Trump at the White House in Washington, DC, on Wednesday, 21 May, to discuss bilateral, regional and global issues of interest. Despite tensions between the two countries, Ntshavheni said the government expects the 'highest level of decorum' when they meet US President Donald Trump. CONTINUE READING: Will Trump embarrass SA at White House meeting? Here's what some of South Africa's SOE bosses earn The Minister of Mineral and Petroleum Resources, Gwede Mantashe, has disclosed detailed information about the remuneration packages of chief executives across state-owned enterprises (SOEs) that fall under his department. The disclosure came in response to a parliamentary question from DA MP Mergan Chetty, who requested comprehensive details about executive compensation at these entities. Minister of Mineral and Petroleum Resources Gwede Mantashe. Picture: Gallo Images/Jeffrey Abrahams According to Mantashe's response, the Central Energy Fund SOE (CEF) Chief Executive Officer, Ishmael Poolo, receives the highest remuneration package among the SOEs, totaling R6 147 526.77 annually. The CEO also received a performance bonus of R2 839 005.15 for the 2023-24 financial year. CONTINUE READING: Here's what some of South Africa's SOE bosses earn 'I'm viewing my options,' says Lesufi on availability for ANC's top positions ANC Gauteng chairperson Panyaza Lesufi said on Thursday that he may not run for election to the party's top seven in 2027. Lesufi would not limit his options to just the party's top seven positions. Panyaza Lesufi during the Gauteng ANC media briefing on 15 May 2025. Picture: Gauteng ANC 'I'm viewing my options. I've been in politics since I was 13 years old. If you speak about 2027, it might be far-fetched. Let's wait. It's not about contestation, there might be other opportunities that might be opened,' said Lesufi. CONTINUE READING: 'I'm viewing my options,' says Lesufi on availability for ANC's top positions Here are five more stories of the day: Yesterday's News recap READ HERE: Top 10 stories of the day: Police probe Fleurhof boy's death | Eskom setbacks | Will Lesufi fire corrupt officials?
