Malnutrition, alcoholism behind widespread TB in South India

Malnutrition and alcoholism are the key drivers of tuberculosis in the southern states of India, scientists say.
Researchers from Boston University School of Medicine (BUSM) in the US and Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER) in Tamil Nadu found a a striking link between malnutrition, heavy alcohol use and tuberculosis (TB) in southern India.
They collaborated on a large cohort study of TB cases, called the Regional Prospective observational Research for Tuberculosis (RePORT).
The study, published in the journal PLOS ONE, aims to identify markers in the blood that predict whether an individual will fail TB treatment and whether their household contacts will develop TB.

The study evaluated those recently diagnosed with TB in Puducherry and Tamil Nadu and compared the study data to population level data in the area.
The researchers calculated that more than 61 per cent of TB cases in women are attributable to malnutrition. The study also found that up to 75 per cent of male TB cases could be eliminated if the impact of alcohol was reduced.

An estimated 10.6 million cases of TB occur annually in the world, and India accounts for 27 per cent, researchers said.
This study comes on the heels of the World Health Organization's (WHO) strategy that encourages research into country-specific TB research plans.

"We hope this demonstration of how malnutrition and alcoholism are driving the TB epidemic in India will help local TB programmes target resources to reduce the local burden of TB," said Natasha Hochberg, assistant professor at BUSM.
"The Indian government has recently released guidelines for the nutritional care of TB patients; we anticipate that our findings will bolster their efforts and renew the emphasis on addressing malnutrition to prevent TB," said Hochberg.
The researchers also note a scarcity of alcohol treatment programmes in the Puducherry and Tamil Nadu region and that heavy alcohol use has an impact on TB treatment outcomes.