Unmasking the human face of TB- The impact of tuberculosis on the families of patients

Background: As per the World Health Organization (WHO) Global Report 2017, among the 9.6 million cases of tuberculosis (TB) that occur annually in the world, 2.8 million are found in India. TB is the biggest killer in the 15 to 49 years age group—an age range during which people are the most productive. It is a disease that creates and thrives in poverty. Several studies have shown that TB has a negative impact on the socioeconomic status of patients. Limited data are available on the long-term impact of this disease on the families of patients. Aims: This study aimed to analyze the impact of TB on the socioeconomic condition and educational status of the family members of patients and the nutritional status of children younger than 12 years in the family of the patient. Methods: This was a retrospective cohort study conducted in Vellore, Tamil Nadu, India in the month of March 2017. The exposed group consisted of families with a member who completed treatment for TB in the past 5 years obtained from two tuberculosis units under the Revised National Tuberculosis Control Programme. The unexposed group was composed of families in the same neighborhood as the exposed families, matched for the age of one child. Results: Upon analysis, the multifaceted impact of TB led to an increased risk of “financial crises,” delayed and disrupted education among children, and wasting among children younger than 5 years (as measured by weight-for-height Z scores). Older children and adults were also at a higher risk of being undernourished as assessed by BMI-for-age Z scores and BMI, respectively. Reduced social participation as a marker of stigma was found to be higher but not statistically significant. Conclusions: This study found that despite the obvious multifaceted impact of TB on the family, the screening and protective measures often fail to encompass the scope of the disease. These are of great importance to the primary physician, often the only contact of the medical fraternity with the family members of patients.