Comorbidities in pulmonary tuberculosis cases in Puducherry and Tamil Nadu, India: Opportunities for intervention

Abstract

BackgroundWe aimed to define characteristics of TB patients in Puducherry and two districts of Tamil Nadu, India and calculate the population attributable fractions (PAF) of TB from malnutrition and alcohol.MethodsNew smear-positive TB cases were enrolled into the Regional Prospective Observational Research for Tuberculosis (RePORT India) cohort. Census and National Family Health Survey data were used for comparisons.ResultsData were analyzed for 409 participants enrolled between May 2014-June 2016; 307 (75.1%) were male, 60.2% were malnourished (body mass index [BMI] <18.5 kg/m2), and 29.1% severely malnourished (BMI <16). “Hazardous” alcohol use (based on AUDIT-C score) was reported by 155/305 (50.8%) of males. Tuberculosis cases were more likely than the Puducherry population to be malnourished (62.6% v 10.2% males and 71.7% v 11.3% of females; both p<0.001), and male cases were more likely to use alcohol than male non-cases (84.4% v 41%; p < .001). The PAF of malnutrition was 57.4% in males and 61.5% in females; the PAF for alcohol use was 73.8% in males and 1.7% in females.ConclusionsAlcohol use in men and malnutrition are helping drive the TB epidemic in Southern India. Reducing the TB burden in this population will require efforts to mitigate these risk factors.

Management of hospitalized drug sensitive pulmonary tuberculosis patients during the Hajj mass gathering: A cross sectional study

“…This is in accordance with global and Hajj-related data and established risk factors for TB [1,7,10,12]. However, the prevalence of coexisting chronic diseases (63%, 17/27) among TB patients, especially diabetes, was higher than that reported internationally as well as previous studies among Hajj pilgrims with TB [7,[12][13][14]. The presence of chronic diseases, increases the risk of TB disease, predisposes to severe illness and complicates TB treatment [1,12].…”

Household food insecurity among patients with pulmonary tuberculosis and its associated factors in South India: a cross-sectional analysis

“…This is a cross-sectional analysis of data from a cohort study under Regional Prospective Observational Research for Tuberculosis (RePORT) India Consortium. Details of the study design have been previously reported 11–14…”

“…Only newly diagnosed smear-positive and culture-positive pulmonary TB cases were included. Details on data collection and procedures were previously reported 11–14…”

Food for Thought: The Role of Undernutrition and Diabetes in India’s TB Epidemic

“…5 We see this play out in India where the Population Attributable Fraction (PAF) of TB due to malnutrition in India can be as high as 61.5% in women and 57.4% in men. 6 The impaired cell-mediated immunity in individuals with severe malnutrition affects the ability to control the infection and increases likelihood of progression to TB disease. 7,8 Not only does undernutrition increase the risk for TB, it also increases the severity of disease.…”