High burden of severe/very severe undernutrition in TB patients with inequitable DBT and food basket distribution.
Authors
Vishnu Gupta, State Health Resource Centre, Raipur, India
Chetanya Malik, Sangwari–People’s Association for Equity & Health, Surguja, India
Kalpita Shringarpure, Department of Community Medicine, Medical College Baroda, Vadodara, India
Himanshu A Gupte, Narotam Sekhsaria Foundation, Mumbai, India
Hemant D Shewade, Division of Health Systems Research, ICMR – National Institute of Epidemiology (ICMR-NIE), Chennai, India
Khemraj Sonwani, Directorate of Health Services, Department of Health and Family Welfare, Raipur, India
Vikash Ranjan Keshri, Associate Professor, Jindal School of Public Health and Human Development, O.P. Jindal Global University, Sonipat, Haryana, India
Summary
Background: Undernutrition drives the TB epidemic in India with 4–5 times higher mortality among adults with severe/very severe undernutrition. We assessed proportion of severe/very severe undernutrition among adults with TB and timeliness in receiving monetary support for nutrition (Direct benefit transfer-DBT) and food baskets.
Research design and methods: This analytical cross-sectional study conducted in Chhattisgarh, tribal Indian state, utilized program data of adults with TB notified in public facilities under the National TB Elimination Program from April-June 2024. Body Mass Index (BMI) was categorized for nutritional status and equity in distribution of DBT and foodbaskets was evaluated using frequency, proportions, and Chi-square for trend.
Results: Of 6568 adults with TB, BMI was calculated for 6397 (97%). Proportion of severe and very severe undernutrition was 22% and 13% respectively. First DBT instalment was received by 81%, with 29% receiving it within two months; 21% received foodbaskets, with similar coverage across all undernutrition categories (p > 0.05), reflecting inequity.
Conclusions: There is a high burden of severe/very severe undernutrition among TB patients. Similar DBT and food basket coverage among those with severe/very severe undernutrition and other TB patients indicates inequity in distribution. Undernutrition-basedindicators and linkage of DBT and food baskets should be prioritized.
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