Title : Public health dietary challenges and associated risk factors of TB care in Raipur district of Chhattisgarh, Central India: Community based study

Introduction: Tuberculosis (TB) is a global public health problem. Undernutrition is most potent risk factor for Tuberculosis. Low circulating concentration of micronutrients such as B 12, D3, and minerals Iron, Zinc and selenium have been reported biological plausibility for active TB.

Material & Methods: Community Based Cross Sectional Study was conducted in 160 newly diagnosed adult Pulmonary TB Patients during June to Nov 2024. After obtaining consent patients were recruited randomly and blood sample were collected for assessment of nutritional biomarkers. Relevant Information was obtained by Predesigned Pretested Questionnaire.

Results: Out of total 160 study subjects studied mean age was 38.01 (SD+-15.69), 65% upper lower socioeconomic status & 21.9% were educated up to middle school, 28.8% were living in poor ventilated home and overcrowding observed in 39.4% households. Among all studied dietary counseling was done among 59.4% study subject of which only 20.6% study subjects were following it. Dietary gap was observed as Calorie & Protein deficient in 88.8%, 79.4% study subjects respectively while 444.73Kcal (SD+-572.98), 26.94gm (SD+-36) mean calorie & Protein deficient. Among all studied 60% had undernourished of them 11.3% found severely malnourished. Micronutrient deficiency was observed as D3 Deficient 83.4%, 80.6% anemic, 50.6% low Cholesterol, 20.6% B12 deficient, low serum iron 14.4% and serum ferritin low in 22.5% study subjects while 10 % had combine micronutrient deficiency. Low level of Vit D, serum ferritin, serum iron was significantly more among undernourished TB patients as compared to normal nutrition.

Conclusion: High proportion of study subjects were Undernourished with significant Calorie and protein gap found in their recommended daily intake. Dietary gap was also associated with various micronutrient Deficiencies. Identified nutrient can be incorporated in the diet through locally available food through better treatment outcome.

Dr Ashish Sinha Professor and Head Dept of Community Medicine,   did MBBS, MD in Community Medicine working as Professor in Pt JNM Medical College Raipur and Director Medical in Sickle Cell Institute Raipur of Chhattisgarh Province India. He had 18yrs of Public Health Experience including 13 Yrs of Teaching and research. He worked in World Health Organization as Surveillance Medical Officer for two years in National Polio Surveillance Project WHO India, National AIDAS Control Organization as State Epidemiologist for 1 year and as Senior Resident at Post Graduate 
Institute of Medical Education and Research Chandigarh. He published 25 Original Research Articles and 15 scientific paper presentation including 5 at International Conferences.