Daijiworld Media Network – New Delhi

New Delhi, Oct 12: A landmark study by Mangaluru-based doctor couple Dr Anurag and Dr Madhavi Bhargava has led the World Health Organisation (WHO) to revise its global tuberculosis (TB) treatment guidelines, placing greater emphasis on food and nutritional support for patients and their families.

The couple, affiliated with Kasturba Medical College and Yenepoya Medical College respectively, conducted a groundbreaking trial funded by the Indian Council of Medical Research (ICMR). Published two years ago, their findings showed that providing nutritional support to household contacts of TB patients reduced new TB infections by nearly half, while improving food and nutrition among patients themselves significantly increased survival rates.

Earlier this week, WHO incorporated these insights into its consolidated guidelines on tuberculosis and undernutrition. Among the key additions is the “provision of food assistance to prevent TB in household contacts of people with TB in food insecure settings.”

WHO noted that the recommendation was informed by results from the Reducing Activation of Tuberculosis by Improvement of Nutritional Status (RATIONS) trial, led by the Bhargavas in collaboration with other researchers.

The trial demonstrated that a monthly food basket—containing 5 kg of rice, 1.5 kg of lentils per adult, and multivitamin tablets—could reduce new pulmonary TB cases among family members by 48 percent. Conducted across four districts in Jharkhand, the study covered around 2,800 patients and more than 10,000 of their household contacts.

“The risk of TB in family members is higher due to the shared environment of poverty and food insecurity. A family-based approach can improve treatment outcomes and reduce the overall TB burden,” said Dr Madhavi Bhargava as quoted by Deccan Herald.

Following the trial’s success, several states, including Jharkhand, Tamil Nadu, and Himachal Pradesh, have begun distributing food baskets to TB-affected families. The Union government has also increased its nutritional support for patients to ensure better access to wholesome food.

India continues to bear the world’s highest TB burden, with over 28 lakh new cases and more than 3.2 lakh deaths in 2023—equating to 37 deaths every hour, according to official data. Karnataka alone records nearly 5,000 TB deaths annually.

“Malnutrition remains the leading risk factor for TB in India. Strengthening nutrition across the population could be a game changer in ending TB,” said Dr Anurag Bhargava.

Their research also revealed that better food availability could reduce TB-related mortality by 35 percent and that patients who gained weight in the first two months of nutritional intervention had a 60 percent lower risk of death.

Subsequent modelling suggested that providing food baskets to even half the TB-affected households in India between 2023 and 2035 could prevent about 4 lakh deaths and 9 lakh new TB cases.

“This was a field-based study, not limited to hospital settings. It is heartening that within just two years, its evidence has influenced WHO guidelines and found a place in medical textbooks,” said Dr Anurag.