Malnutrition, alcoholism behind widespread TB in South India

With alcoholism blocking the chances of eliminating TB from southern India, medical researchers have suggested incorporating alcohol treatment as a part of the TB control programme at least in those states, where consumption of alcohol is high.
 
The suggestion came following a trial conducted in Puducherry and parts of Tamil Nadu. It found up to 75% of male TB cases could be eliminated if the impact of alcohol was reduced.
 
They found alcohol use results in poor treatment adherence and worsens treatment outcomes including death. By reducing alcohol use, TB cases would be fewer.
 
Alcohol use among TB cases varies widely with rates as high as 29% in Chennai and 20% in Karnataka.
 
The researchers pointed out that integration of alcohol treatment into the tuberculosis control programme might be less critical in some areas of India, but it certainly could have value for many other areas. The sites chosen for the study are Puducherry and Cuddalore and Villapuram districts of Tamil Nadu.
 
The research by scientists from Boston and Rutgers universities in the USA, and Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry found alcohol abuse is an overwhelmingly male phenomenon while malnutrition is a key perpetuating factor among women.
 
Poor nutrition standards were seen in TB patients of both genders, but the numbers are higher for women (61.5%) as against the males (57%). Alcohol abuse, on the other hand, was minimal among women. Almost all of the 409 participants of the study are from scheduled or backward caste.
 
“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 of medicine at Boston University's School of Medicine and corresponding author of the study.
 
An estimated 10.6 million cases of TB occur annually in the world, and India accounts for 27% of these cases. A renewed sense of urgency to control the disease now comes from the emergence of drug-resistant TB cases, which are difficult to treat and have higher mortality.

The study has been published in the August 23 issue of the journal PLOS One.