Aug 30 (5 days ago)
National Human Rights Commission,
I want to bring your kind attention towards the news paper link of English daily news paper "The Telegraph'' on August 30 , 2014, edition regarding "Lack of food behind half of TB cases- Holes in control bid'' (news clipping file annexed).
Lack of food behind half of TB cases- Holes in control bid
New Delhi, Aug. 29: Poor nutrition is the biggest contributor to India’s burden of tuberculosis and explains why the number of new patients each year has remained nearly static despite two decades of TB control efforts, a research study has suggested.
The study has found that the infections in about 55 per cent of patients — including 67 per cent in girls between 15 and 19 years and 62 per cent in adolescent boys — appear linked to under-nutrition.
Health researchers at the Himalayan Institute of Medical Sciences (HIMS), Dehradun, and McGill University in Montreal, Canada, who conducted the study say their findings highlight a key factor that activates TB infection but has been largely ignored by health authorities.
“Our TB control efforts have focused almost exclusively on biomedical aspects — a vaccine given during infancy, diagnosis and drug-therapy,” said Anurag Bhargava, a senior medicine consultant at the HIMS and the study’s lead author.
The findings were published today in The National Medical Journal of India.
The vaccine does not provide long-term protection. India’s incidence of TB — new cases per year — has remained fairly static at about 175 per 100,000 population over the past decade. India’s public health system had documented over 1.2 million cases in 2012.
The bacilli that cause TB may remain dormant and silent in the body for years without causing any symptoms until factors such as poor nutrition, smoking or diabetes suppress the immunity and cause active disease.
Health experts estimate that nearly 400 million people in India are already infected but have no symptoms because their immune systems are keeping the TB bacilli in check. But impaired immunity puts them at risk of developing active disease.
“With the focus on diagnosis and drugs, the importance of nutrition has been ignored,” said Soumya Swaminathan, director of the National Institute For Research in Tuberculosis, Chennai, who was not associated with the study.
But while the TB control programme is responsible for diagnosis and treatment, Swaminathan and other experts say, ensuring adequate nutrition for the population could be seen as a task that would involve other non-health arms of the government.
The study by Bhargava and his colleagues used national data on under-nutrition to derive estimates for the proportion of TB cases that could be explained through this factor. “This (55 per cent) is a big fraction,” said Madhukar Pai, an epidemiologist at McGill University and co-author of the study. “It suggests that unless we tackle malnutrition, it may be difficult to control TB,” Pai said.
An earlier study published four years ago by health officials who manage the country’s TB programme had estimated that under-nutrition contributes to only about 31 per cent of the cases, while the proportion linked to HIV infections — that also lead to suppressed immunity — was estimated to be 11 per cent.
It has been estimated that smoking accounted for 9 per cent and diabetes for 5 per cent of active TB infections.
However, the analysis by the HIMS-McGill team found that in three eastern states — Bihar, Chhattisgarh and Jharkhand — the fractions of TB cases associated with poor nutrition were above 60 per cent.
“For all the hype about economic growth, the epidemic proportions of poor nutrition and TB suggests that India has a long way to go to address inequity and improving the health of the poor,” Pai said.
Therefore it is kind request please take appropriate action at earliest.
Dr. Lenin Raghuvanshi
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Peoples' Vigilance Committee on Human Rights/Jan Mitra Nyas
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