Nutritional care for TB-affected households is likely to be highly cost-effective & could avert a substantial amount of disease and death in India – our paper out now in Lancet Global Health @raclark18.bsky.social @reinhouben.bsky.social @lshtm-tbmod.bsky.social www.sciencedirect.com/science/arti... - ThreadSky

cfmcquaid.bsky.social • 43 days ago

Nutritional care for TB-affected households is likely to be highly cost-effective & could avert a substantial amount of disease and death in India – our paper out now in Lancet Global Health @raclark18.bsky.social @reinhouben.bsky.social @lshtm-tbmod.bsky.social https://www.sciencedirect.com/science/article/pii/S2214109X24005059

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cfmcquaid.bsky.social•43 days ago

We used a BMI-explicit transmission model to compare provision of a nutritional intervention to 50% of adults on TB treatment & their household contacts from 2023-2035. We found this could prevent 360,000 TB deaths and 880,000 disease episodes, with an ICER of $167 per DALY averted

cfmcquaid.bsky.social•43 days ago

Only 10 households needed to receive support to prevent one TB case, and 24 to prevent one TB death.

***Key message*** nutritional support for TB-affected households is cost-effective, and a potentially important tool in ending TB

cfmcquaid.bsky.social•43 days ago

@richardwhite321.bsky.social @tbtakenseriously.bsky.social @cmmid-lshtm.bsky.social @lshtm.bsky.social

drmel.bsky.social•43 days ago

Hi, this is very interesting! Do you check for H. pylori co-infection as well? Has been associated with aberrant iron metabolism in the host.

cfmcquaid.bsky.social•43 days ago

Hi - I'm afraid we didn't, as we were basing our analysis on the results from an RCT (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01231-X/fulltext) - I don't believe they did check though. @tbtakenseriously.bsky.social certainly has some thoughts on enteropathogens & what this means for TB care!

drmel.bsky.social•43 days ago

I’m biased as I published on this topic with Paeds folks on an EU framework 6 grant CONTENT) and did mouse work to look at molecular causation, back in the day. The rate of life long H. pylori carriage in India is pretty high? At least 1/3 of the population?

tbtakenseriously.bsky.social•43 days ago

Absolutely— there’s bound to be malabsorption unless we address factors like enteropathogens. Our recent data show that 40% of PWTB in South India had helminth infections, predominantly hookworms!

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