Tamil Nadu has prioritised the nutritional status of patients diagnosed with tuberculosis (TB) and identified as severely ill and undernourished.
In an initiative of its own, the State TB Cell has roped in volunteers to provide food baskets containing a recommended portion of high-protein food, and in the past one year, has reached out to 38,235 patients across the State.
Under the scheme, the Tamil Nadu Kasanoi Erappila Thittam (TN-KET), the well-being of patients is assessed at the point of diagnosis. Those with very severe undernutrition or respiratory insufficiency or poor performance status (unable to stand without support) are prioritised for a comprehensive assessment and inpatient care.
“At the time of detection of TB, their height, weight and Body Mass Index and respiratory rate are measured. Through this triaging, we identify patients who are severely ill and have severe under-nutrition. Such patients are counselled and sent to government hospitals where we have trained physicians to assess and admit them. We have identified 150 such nodal centres at secondary level institutions,” Asha Frederick, State TB Officer, said.
Physicians look for co-morbid conditions and assess if the patient is ill due to TB alone, or has co-existing conditions such as diabetes, she added.
Nurses trained
Head nurses of government medical college hospitals and some government hospitals were trained in providing formula-based food made using puffed rice powder, milk and ghee for those patients who are unable to swallow food either through spoon-feeding or through a Ryle’s tube.
“Patients are admitted for a minimum of seven days during which the side effects of TB drugs, if any, can be managed, co-morbidities such as diabetes can be controlled and nutritional counselling can be provided. We have been prioritising such severely ill patients,” she said.
Field staff also visit the patients at their homes a month after hospitalisation. “Simultaneously, we roped in individuals, voluntary organisations and firms to support these patients with nutritional food. In the past one year, 20,235 persons have come forward to provide food baskets to patients. We recommend high-protein food and the baskets, very often, contain peanuts, pulses such as chickpeas and eggs. Some also provide protein powder. About 25 to 30% of the patients diagnosed with TB are diabetic. So, we are concentrating on a protein-rich diet for all,” Dr. Asha said.
This, the official said, will help in reducing mortality. “In the severely ill, death mostly occurs in the first two to three months after initiating treatment. One of the symptoms in TB is a loss of appetite, and such efforts help in restoring the patients’ appetites. Through this, we are addressing adult under-nutrition,” she pointed out.
The outcomes are being tracked: field-level staff are observing a return of appetite in patients, while awareness of continuing to maintain good protein diet and not compromising on food habits is created among patients. The patients’ weights are also checked once every two months, she said.
