Effectiveness of nutritional counselling on nutritional status and treatment outcomes among tuberculosis patients registered under NTEP in Eastern India - A cluster-randomised controlled trial
Beenit K. Jena, Binod K. Behera, Arvind K. Singh, Binod K. Patro
A
BSTRACT
Background:
Tuberculosis (TB) remains a significant public health issue in India, with undernutrition worsening disease outcomes through weight loss, deficiencies, and higher mortality. While financial incentives under the Nikshay Poshan Yojana have improved adherence, the impact of structured nutritional counselling is underexplored.
Objectives:
To evaluate the effectiveness of nutritional counselling with dietary planning on nutritional status and disease outcomes among TB patients.
Materials and Methods:
A two-arm, parallel, open-label, cluster-randomised controlled trial was conducted in Khordha district, Odisha, among TB patients aged ≥18 years registered from January to November 2023. Patients with MDR/XDR TB, extrapulmonary TB, terminal illness, or inability to follow the intervention were excluded. A total of 156 patients were randomised equally into intervention and control groups. The intervention group received structured nutritional counselling and dietary planning; the control group received standard care. Data included sociodemographic details, nutritional knowledge, anthropometry, and dietary intake using a seven-day recall. DOTS providers in the intervention arm were trained for nutritional counselling.
Results:
Among 152 patients analysed (79 intervention, 73 control), the intervention group showed significantly better dietary knowledge (57.7% vs. 19.2%) and caloric intake (2107 ± 297 kcal vs. 1766 ± 411 kcal). Median weight gain was higher (7 kg vs. 4 kg,
Conclusion:
Structured nutritional counselling improved nutritional status among TB patients. Integrating tailored dietary support and training DOTS providers may strengthen TB care and improve patient outcomes.