Abstract
Poverty, food insecurity and poor nutrition in the population are important contributors to the burden of tuberculosis (TB). For poor and food-insecure individuals, accessing and successfully completing anti-tuberculosis treatment over an extended period of time is challenging. Food and nutritional support as an incentive and enabler is employed by national TB control programmes (NTPs) worldwide as a means to encourage treatment initiation and adherence and to improve the nutritional status of patients with TB. It also offers a safety net for food-insecure households affected by TB to mitigate the financial consequences of the disease. This paper reports on the primary lessons from the review of the World Food Programme's (WFP's) Food Assistance Programme for TB patients in Afghanistan. It aims to inform the design, implementation and scale-up of TB programmes in settings where food insecurity and malnutrition are prevalent. It also documents qualitative findings that suggest that patients, their families and providers viewed food support as an important asset and an essential element of the national TB control strategy. While the impact on treatment success or case detection could not be quantified, it is likely that the WFP intervention had a positive impact on the patients and their households, therefore contributing to the success of the DOTS-based NTP.
Highlights
Poverty, food insecurity and poor nutrition in the population are important contributors to the burden of tuberculosis (TB)
The Food Assistance Programme had three specific objectives: 1) to increase the adherence of TB patients to directly observed therapy (DOT) and improve the anti-tuberculosis treatment success rates, 2) to increase TB case detection rates by supporting households affected by TB, and 3) to mitigate increased vulnerability to food insecurity among TB-affected households.[23]
While this review could not quantify the impact of the food assistance programme on case detection and treatment success, the qualitative data gathered during the appraisal seem to suggest that the World Food Programme (WFP) interventions were successful in reducing the pressures of disease on household food security and the household economic situation by providing family rations to TB patients through the treatment centres
Summary
Food insecurity and poor nutrition in the population are important contributors to the burden of tuberculosis (TB). Food and nutritional support as an incentive and enabler is employed by national TB control programmes (NTPs) worldwide as a means to encourage treatment initiation and adherence and to improve the nutritional status of patients with TB. It offers a safety net for food-insecure households affected by TB to mitigate the financial consequences of the disease. For individuals who are poor and food-insecure, accessing and successfully completing anti-tuberculosis treatment over an extended period of time (usually 6–8 months for drug-susceptible disease) is often challenging.[15,16] Maximising treatment adherence is crucial, for the individual and for the community, to reduce transmission and avert the risk of generating drug-resistant strains.
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