CHALLENGES AND STATUS OF TUBERCULOSIS CONTROL IN INDIA

Tuberculosis, a communicable bacterial disease, is one of the top 10 causes of death worldwide, with about 1.4 million people estimated to have died from this disease in 2019.

Caused by the bacterial species mycobacterium, Tuberculosis primarily affects the lungs but can also attack the spine, intestines and brain. India bears the highest global burden of TB, with an incidence of 26.9 lakh cases in 2019. Even as the world struggles with the challenge of ensuring treatment for all, multi-drug-resistant TB has emerged as a major concern, obstructing the goal of TB elimination.

Antibiotic prescription for six to nine months is the primary line of treatment for TB and in a majority of cases, successfully treats the affected patients. In recent years, healthcare providers, researchers, and common people have evinced greater interest in exploring the potential of naturopathy and other alternative systems of medicine in enabling better management of TB and paving the way for better recovery of patients.

CAN NATUROPATHY HELP IN TB TREATMENT?

Naturopathy is a nature-based medicine that uses multiple mechanisms, including herbs, diet management, yoga and lifestyle changes to boost the human body’s capacity to heal.

Being a drugless form of medicine, naturopathy is also highly safe and even helps the body deal with the side effects of certain modern medicines.

A number of herbal remedies have been found to have anti-TB benefits and, when given along with anti-TB drugs, can aid the body towards a faster recovery. Most importantly, herbal formulations help significantly reduce liver toxicity, a prominent side effect of long-term consumption of antibiotics.

TB bacteria are rampant in the Indian environment. In fact, a large number of people carry the bacteria latently. The bacteria can easily attack a body whose immunity has withered down due to different reasons, including nutritional deficiencies or other diseases. Naturopathy plays an important role in boosting immunity and strengthening the body’s defences against viruses and bacteria. In this light, widespread use of naturopathic practices and herbal remedies can also act as a preventive bulwark against Tuberculosis.

NATUROPATHIC AND HERBAL INTERVENTIONS FOR TB

The side effects caused by anti-TB drugs are significant in some patients and include potentially dangerous liver toxicity as well as kidney toxicity. In fact, hepatotoxicity forces many patients even to discontinue treatment. In case of multi-drug resistant Tuberculosis, and even more difficult, multiple treatment lines are prescribed, which has graver toxic effects on the body.

Plant extracts from selected herbs have been found to be highly useful in reducing the toxic effects of anti TB drugs. The phytochemicals, flavonoids, and glycoside compounds in plant extracts act as antioxidants and help prevent free radical damage and restore normal hepatic enzymes, thereby enabling a better recovery path for patients. They also help reduce serum enzymes, total bilirubin, and protein levels.

A study published in the Journal of Ayurveda and Integrative medicine in 2012 used Aswagandha and the multi-herbal formulation Chyawanprash as an adjunct therapy for patients taking anti TB drugs. An analysis of these patients over a period of time revealed improvement in symptoms as well as body weight, normal ESR values, improvement in IgA and IgM patterns as well as increased bioavailability of isoniazid and pyrazinamide.

Another study published in the Indian Journal of Tradit Knowl in 2004 found that patients on anti TB drugs, when supplemented with herbal supplements Aloe vera extract, Berberis aristata root, Solanum nigrum as well as Phyllanthus fraternus, showed normal liver enzyme activity at the end of the 12-week trial. On the other hand, patients in the placebo group showed a rise in ALT and AST levels which are markers of hepatotoxicity.

A series of medicinal plants used in Ayurvedic practice such asA. indica (neem), Apium graveolens (ajmoda) and Fumaria indica (pitpapra), to name a few have also been found to have antimicrobial activity against TB bacteria.

At the same time, a number of other Indian herbs, plants and remedies with anti-inflammatory properties such as garlic, mint, amla, honey etc also help patients fight off the ill effects of TB and improve their quality of life. 

Despite the availability of an antibiotic regimen, TB continues to pose a heavy healthcare burden across the world. With the emergence of multi-drug-resistant TB, an increasing need has been felt to find adjuvant therapies and herbal remedies that can aid patient recovery and contain the toxic effects of chemical-based drugs.

In such as scenario, developing an integrated approach to TB involving both modern medicine and naturopathy can help derive significant treatment benefits for patients.

The writer is a Senior Naturopath,  Jindal Naturecure Institute.