WHO Updates TB Treatment Guidelines Following Pioneering Research

Research conducted by a doctor couple from Mangaluru has led to a significant update in the World Health Organization’s (WHO) guidelines for tuberculosis (TB) treatment. The new guidelines emphasize the importance of food and nutritional support for the families of TB patients as a strategy to prevent new infections.

Anurag Bhargava and Madhavi Bhargava, affiliated with Kasturba Medical College and Yenepoya Medical College respectively, published their groundbreaking findings two years ago. Their study, supported by the Indian Council of Medical Research, revealed that providing food support to household contacts of TB patients can reduce the incidence of new TB cases by nearly 50%. This research also indicated that nutritional assistance for TB patients significantly enhances their chances of survival.

Earlier this week, the WHO released its consolidated guidelines on tuberculosis and undernutrition. Among the key updates is the recommendation for “provision of food assistance to prevent TB in household contacts of people with TB in food insecure settings.” The WHO referenced five studies conducted by the Bhargavas in collaboration with other researchers, highlighting the effectiveness of their approach.

The Bhargavas’ research involved approximately 2,800 patients and over 10,000 family members across four districts in Jharkhand. They demonstrated that a monthly food basket containing 5 kilograms of rice and 1.5 kilograms of lentils per adult, along with multivitamin tablets, could decrease new cases of contagious pulmonary tuberculosis by 48%.

Madhavi Bhargava noted, “The risk of TB in family members is much higher due to the shared environment of poverty and food insecurity. A family-based approach is promising not just for patient outcomes but also in reducing the overall TB burden in the long term.”

In response to the trial’s findings, the governments of Jharkhand, Tamil Nadu, and Himachal Pradesh have initiated programs to distribute food baskets to households of TB patients. Additionally, the Union government has increased its financial support to help these families access better food and nutrition.

India continues to grapple with the highest TB burden globally, with over 2.8 million new cases and more than 320,000 deaths reported in 2023. This translates to approximately 37 deaths per hour due to TB, according to official data. In Karnataka, nearly 5,000 people succumb to the disease each year.

Anurag Bhargava emphasized that malnutrition is a critical risk factor for TB in India. He pointed out that improving nutrition within the general population could significantly impact efforts to eradicate TB.

Another significant outcome of their research showed that enhanced food availability can reduce mortality among TB patients by 35%. Furthermore, weight gain during the first two months of receiving food support decreases the risk of TB mortality by 60%.

Modeling studies indicate that providing food baskets to at least 50% of families with a TB patient in India could prevent approximately 400,000 deaths and 900,000 new TB cases between 2023 and 2035.

“This trial generated evidence from field observations rather than from a hospital or laboratory setting. It is encouraging that these results have been integrated into medical textbooks and WHO guidelines within just two years,” Anurag Bhargava remarked.

The WHO’s updated guidelines underscore the critical role of nutrition in combating tuberculosis, marking a pivotal moment in public health strategy and offering hope for better health outcomes for millions affected by this disease.