Does nutritional support under programmatic settings result in weight and body mass index changes among tuberculosis patients? Evidence on the impact of nutritional support through Pradhan Mantri Tuberculosis Mukt Bharat Abhiyan under national tuberculosis elimination programme from Ramgarh district of Jharkhand
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20240897Keywords:
Pradhan mantri TB mukt bharath abhiyan, Ni-kshay mitra, Nutritional support in TBAbstract
Background: To increase community participation in tuberculosis (TB) elimination efforts, the government of India has launched ‘Pradhan Mantri TB Mukt Bharath Abhiyan’ (PMTBMBA) under the national TB elimination programme. The scheme allows interested parties (Ni-kshay mitras) to offer nutritional support to TB patients. This study aims to understand the impact of such a support in improving weight and body mass index (BMI) among TB patients as most available evidence comes from research settings.
Methods: This is a retrospective cross-sectional study carried out in Ramgarh district of Jharkhand, India, for the period first quarter 2023. Relevant data was extracted from Ni-kshay web portal and TB treatment cards. The data is analyzed using excel 365.
Results: Of the 114 participants, 69 received nutritional support during the entire duration of treatment and 45 received support partially. Single factor ANOVA on weight and BMI gain revealed statistically significant difference in mean weight/BMI between the two groups with F (1, 110)=35.4660, p=3.16×10-08 and F (1, 110)=22.9994, p=5.12×10-06. Correlation analysis showed a moderate correlation between the number of nutritional kits received and the weight/BMI gain with correlation coefficients r=0.5, p=1.07×10-07 and r=0.4, p=1.65×10-05 respectively.
Conclusions: The study concludes that the impact of nutritional supplementation in programmatic setting is comparable with that of implementation research study settings.
References
World Health Organization. 2023. Global tuberculosis report 2023. Available at: https://iris.who.int/. Accessed on 12 January 2024.
Government of India. Guidance Document- Nutritional Care and Support for TB patients in India. In Central TB Division, Ministry of Health and Family Welfare. 2017. Available at: https://tbcindia.gov.in/index1.php?lang=1&level=3&sublinkid=4731&lid=3277. Accessed on 12 January 2024.
Government of India. Guidance Document - Pradhan Mantri TB Mukt Bharat Abhiyan. Central TB Division, Ministry of Health and Family Welfare. 2022. Available at: https://tbcindia.gov.in/ index1.php?lang=1&level=1&sublinkid=5630&lid=3670. Accessed on 12 January 2024.
Tata Steel Foundation to implement Pradhan Mantri TB Mukt Bharat Abhiyaan. Biz Industry. 2022. Available at: https://www.bizindustry.in/post/tata-steel-foundation-to-implement-pradhan-mantri-tb-mukt-bharat-abhiyaan. Accessed on 12 January 2024.
Bhargava A, Bhargava M, Meher A, Teja GS, Velayutham B, Watson B, et al. Nutritional support for adult patients with microbiologically confirmed pulmonary tuberculosis: outcomes in a programmatic cohort nested within the RATIONS trial in Jharkhand, India. Lancet Global Health. 2023;11(9):e1402-11.
Howell E, Dammala RR, Pandey P, Strouse D, Sharma A, Rao N, et al. Evaluation of a results-based financing nutrition intervention for tuberculosis patients in Madhya Pradesh, India, implemented during the COVID-19 pandemic. BMC Glob Publ Heal. 2023;1(1).
Singh AK, Siddhanta A, Goswami L. Improving tuberculosis treatment success rate through nutrition supplements and counselling: Findings from a pilot intervention in India. Clin Epidemiol Global Heal. 2021;11.
Khan A, Sterling TR, Reves R, Vernon A, Horsburgh CR. Lack of weight gain and relapse risk in a large tuberculosis treatment trial. Am J Respiratory Critical Care Med. 2006;174(3):344-8.
Oxlade O, Huang CC, Murray M. Estimating the impact of reducing under-nutrition on the tuberculosis epidemic in the Central Eastern States of India: A dynamic modelling study. PLoS One. 2015;10(6):1.
World Health Organisation. Guideline: Nutritional care and support for patients with tuberculosis. Geneva, Switzerland: WHO. 2013. Available at: http://apps.who.int/iris/bitstream/handle/10665/94836/9789241506410_eng.pdf;jsessionid=8CC47E8D978C96ED163400F3D32BD139?sequence=1. Accessed on 12 January 2024.
Darnton-Hill I, Mandal PP, De Silva A, Bhatia V, Sharma M. Opportunities to prevent and manage undernutrition to amplify efforts to end TB. Int J Tuberculosis Lung Dis. 2022;26(1):6-11.
