The tribal population in India has a substantially higher prevalence of pulmonary tuberculosis (TB) than the general population due to poor nutrition levels, smoking, and alcohol consumption, a recent study has revealed.
Tribal groups, while diverse, share poor health indicators and increased levels of morbidity and mortality across India. They also have limited access to health services. The study, headed by Beena Thomas, a scientist at the National Institute for Research in Tuberculosis, Chennai, was conducted between 2015 and 2020 among tribals aged more than 15 years.
The researchers screened 74,532 individuals and found the prevalence of TB among tribes to be 432 per 100,000 population. In the general population, TB is prevalent among 350 per 100,000 population.
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India accounts for more than 1/4th of TB cases reported globally. While the Government of India has taken major steps towards the elimination of TB, the disease continues to be a health problem. Multiple surveys have been conducted since 1955 but most of them have excluded the readings of tribal populations. The study, published in the PLOS ONE journal, hence, reveals that tribals, which constitute 8.6% of India’s population, are the ones most impacted by the disease.
Since studies on TB among tribal populations have often been limited to central India, tribal villages (clusters) were selected based on populations proportional to estimated size, from across the country. A sample of 92038 tribals was considered for the survey. The team visited 88 villages from 6 zones: North, West, South, Central, and North East. The prevalence of TB among these regions was as follows:
It found that TB prevalence per 100,000 people was highest in the central zone (625) and lowest in west zone (153). The study also listed state-based variants among the prevalence of TB. Odisha had the highest prevalence (803 per 10,000) while Jammu and Kashmir had the lowest (127 per 100,000)
“This understanding is crucial in planning and implementing need-based strategies for TB control in the tribal population even as we work towards the vision of ending TB in 2025,” Beena Thomas told SciDev. The study also stressed the need to expand research into tribal regions apart from central India. “This indication calls for more studies to be conducted at the zonal and state level across India as current studies seem to be confined largely to central India. By focusing on just central India the problems associated with TB among the tribal populations have only been explored for the tribal populations in this area,” the study read.
The team also found that the presence of TB increased with age among the tribal groups. A majority of TB positive patients were found to be in the age group of 56-65 years, and most were males. Weight loss, night sweat, and blood in the sputum (mixture of saliva and mucus) was a dominant symptom of TB among the tribals surveyed.
“The reasons for the high prevalence of PTB among the central India tribal communities have been attributed to various social and structural factors which included poverty, housing, access to health care facilities, lack of awareness on TB, alcohol, smoking, and poor nutrition,” the study concluded.