March 24, 2014
To prevent malnutrition and improve the nutritional status of people affected by infectious diseases, particularly HIV and TB, FANTA supports implementation of the nutrition assessment, counseling, and support (NACS) approach in a number of target countries. In observation of World TB Day, Dr. Serigne Diene, Technical Advisor for Nutrition and Infectious Diseases – Country Programs, and Rebecca Egan, Technical Advisor for Nutrition and Infectious Diseases, discuss why nutrition is so important in the treatment of TB.
This year’s World TB Day focuses on collaboration among partners from all sectors to find and treat tuberculosis. What is the relationship between nutrition and TB?
There is an established relationship between poor nutrition and increased susceptibility to TB and other diseases (see the figure at right). Undernutrition weakens the immune system, which worsens the effects of infection, which then increases the likelihood of undernutrition. Infections like TB can reduce appetite, decrease the body’s absorption of nutrients, and increase nutrient metabolism to repair the immune system. In addition, people who are undernourished are more susceptible to TB infection. Particularly in instances of poverty and food insecurity, this synergistic relationship between undernutrition and TB often leads to a high prevalence of undernutrition among people with TB.
How can nutrition interventions be used to break this cycle and improve health outcomes for people being treated for TB?
While nutrition is often integrated into care and treatment services for people with HIV, nutrition and social services have not been a core component in TB care and treatment. There is evidence that TB treatment alone is often not enough to improve the nutritional status of patients, which underscores the need for nutrition screening, assessment, and management as integral components of TB treatment and care.
FANTA supports work related to nutrition and infectious diseases in many developing countries. Can you give an example of how the integration of nutrition improves services provided to patients with TB?
FANTA’s support has focused on strengthening nutrition care and support for HIV and TB patients by integrating the NACS approach into countries’ routine HIV and TB services, national policies, and strategic plans. For instance, in Ethiopia, we are developing guidance on infectious diseases and nutrition to be incorporated into national guidelines on clinical and programmatic management of TB and TB/HIV. In Ghana, we helped facilitate the monitoring of NACS and TB services through a district health management information system. In Côte d’Ivoire, FANTA is providing technical support to conduct a situational analysis of nutrition services offered in TB treatment centers. In these and other countries, FANTA is working with government counterparts, implementing partners, and other stakeholders to improve services for patients with TB through appropriate and effective nutrition interventions.