ArticleThe Lancet. Global health2025
Estimating the epidemiological and economic impact of providing nutritional care for tuberculosis-affected households across India: a modelling study.
Article in The Lancet. Global health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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14 citing papers in PubMed.
- Towards ending tuberculosis in South Africa: an uncertainty analysis of the programmes and factors most critical to future declines.Global health action · 2026Article
- Global, regional, and national tuberculosis burden associated with six suboptimal dietary exposures from 1990 to 2021: a comparative risk assessment based on the Global Burden of Disease Study 2021.Journal of thoracic disease · 2026Article
- Cost-effectiveness of in-kind nutritional support for impoverished persons with tuberculosis to reduce mortality and disengagement from care in India: a modelling study.BMJ global health · 2026Article
- From DOTS to DOST: a new framework for TB elimination in India.The Lancet regional health. Southeast Asia · 2026Review
- In-kind Nutritional Supplementation for Persons With Drug-susceptible Tuberculosis and Their Household Contacts Would be Cost-effective for Reducing Tuberculosis Incidence and Mortality in Jharkhand, India: A Modeling Study.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- The eight pillars of within-host tuberculosis modelling.Frontiers in immunology · 2026Review
- Global Burden of Tuberculosis and Drug-Resistant Subtypes Among Women of Childbearing Age from 1990 to 2021, with Projections to 2030.International journal of women's health · 2026Article
- Tuberculosis- learning about experience with nutritional supplementation (TB LENS): Perspectives on a nutritional supplementation for persons with TB and their household contacts.Global public health · 2025Article
- The latent tuberculosis infection survey using two interferon γ release assay tests among the elderly in a well-confined rural county in Eastern China.BMC geriatrics · 2025Article
- The potential impact, cost and cost-effectiveness of tuberculosis interventions - a modelling exercise.medRxiv : the preprint server for health sciences · 2025Article
- Article
- Modelling the effect of a nutritional shock on tuberculosis in India.BMC global and public health · 2025Article
- Evaluating disability, comorbidities and risk factors after TB treatment: an 18-24 month follow-up.IJTLD open · 2025Article
- Qualitative study of acceptability, benefits, and feasibility of a food-based intervention among participants and stakeholders of the RATIONS trial.PLOS global public health · 2025Article
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12 authors.
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Abstract
backgroundApproximately 20% of global tuberculosis incidence is attributable to undernutrition, increasing to more than a third in India. Targeting nutritional interventions to tuberculosis-affected households is a policy priority, but understanding of epidemiological and economic impacts is limited. We aimed to estimate the population-level epidemiological and economic effect of such an intervention.
methodsWe used a previously published, age-stratified, compartmental transmission model of tuberculosis in India, and incorporated explicit BMI strata linked to disease progression and treatment outcomes. We used results from a recent trial of an intervention in which nutritional support in the form of food baskets was provided to people initiating tuberculosis treatment and to their household contacts (1200 kcal for patients and 750 kcal for contacts) to inform estimates of the impact and costs of nutritional support. We estimated the numbers of cases of tuberculosis disease and deaths due to tuberculosis disease that could be averted from 2023 to 2035 under the intervention scenario.
findingsCompared with a baseline with no nutritional intervention, at 50% coverage of adults on tuberculosis treatment and their households (around 23% of households affected by incident tuberculosis in India), providing the nutritional support intervention could prevent 361 200 (95% uncertainty interval 318 000-437 700) tuberculosis deaths and 880 700 (802 700-974 900) disease episodes from 2023 to 2035. This would be equivalent to averting approximately 4·6% (4·2-5·5) tuberculosis deaths and 2·2% (2·1-2·4) tuberculosis episodes. The additional health system cost would be US$1349 million (1221-1492), with an incremental cost-effectiveness ratio of $167 (147-187) per disability-adjusted life-year averted. The median number of households needed to treat to prevent one tuberculosis death was 24·4 and to prevent one tuberculosis case was 10·0.
interpretationA nutritional intervention for tuberculosis-affected households could avert a substantial amount of tuberculosis disease and death in India, and would be highly likely to be cost-effective on the basis of the tuberculosis-specific benefits alone.
fundingNone. TRANSLATIONS: For the Bangla and Hindi translations of the abstract see Supplementary Materials section.
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