Under-nutrition brings with it the risk of death in a person with tuberculosis (TB). And this is the critical indicator that N-TB, a mobile phone-based nutrition assessment and counselling application is looking to address.

Weight is the indicator that is often monitored in treating TB, but height too, is critical in getting the actual picture, explains Anurag Bhargava, Professor of Medicine at Mangalore's Yenepoya Medical College. It may be obvious that a woman who is 30 kg is underweight. “But when you calculate that the BMI (Body Mass Index) is 11, that's when the threat to life becomes clear,” he explains. And this becomes significant given the high levels of TB mortality, estimated at 4,23,000 deaths in India.

N-TB allows healthcare workers who handle TB patients calculate the right BMI and nutrition levels. The app will be launched on World TB Day (March 24).

It is based on the Guidance Document on nutritional care and support for patients with tuberculosis in India that was released by the Revised National Tuberculosis Control Programme (RNTCP) last year. And while the Center for Nutrition Studies, Yenepoya University provided the content for the app, it was developed with technical support from McGill International TB Centre, Montreal.

Demystifying diets

N-TB also helps demystify dietary counselling, says Bhargava, by helping to calculate the nutritional value of foods such as pulses and fruits. There is a misconception that the more expensive the food is, the better it is. Bananas, guavas and eggs, for instance, he says are good nutritional options.

Weightloss from TB can further aggravate underlying under-nutrition, says Bhargava, a seasoned TB researcher. And undernourished patients are at higher risk of serious side-effects from drugs, poor absorption of drugs, reduced ability to return to work, and recurrence of disease after cure.

Govt support

The issue has also been touched upon in the Union Budget 2018 where ₹500 per month is being given to TB patients for nutritional support. This is to become operational from April. Last week the government further tightened the reporting of TBby making it mandatory for doctors and pharmacies treating or dispensing medicines respectively to notify the same with local health authorities, or face penalties including prison time.

Under-nutrition in TB patients is now considered a medical condition like co-existing diabetes, or HIV infection. And the World Health Organisation recommends that nutritional assessment, counselling and support be an integral part of TB care.

N-TB is endorsed by the RNTCP and the World Health Organisation (India), say the institutions who worked on it and Bhargava hopes that medical professionals and nurses in private hospitals also use the app while treating their TB patients. The app was among the new initiatives unveiled by Prime Minister Narendra Modi during the recently concluded TB Summit, they said.

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