Malnutrition and alcoholism are the key drivers of tuberculosis (TB) epidemic in southern India, a research based on Puducherry and Tamil Nadu has revealed. An estimated 10.6 million cases of TB occur annually in the world, and India accounts for 27 per cent. The findings showed that malnutrition attributes to more than 61 per cent of TB cases in women, while alcohol was responsible for up to 75 per cent of TB cases in males. Alcohol use results in poor TB treatment adherence and worse TB outcomes, including death, while closer integration between TB control programs and alcohol treatment programs may improve outcomes, the researchers noted. “Alcohol use in men and malnutrition are helping drive the TB epidemic in Southern India. Reducing the TB burden in this population will require efforts to mitigate these risk factors,” said Sonali Sarkar, from Jawaharlal Institute of Postgraduate Medical Education and Research, in Puducherry. For the study, which appear in the journal PLOS ONE, the team evaluated those recently diagnosed with TB in Puducherry and and two districts of Tamil Nadu — Cuddalore and Villapuram — and compared the study data to population level data in the area. In addition, one-third of the participants were former smokers and 14.8 per cent are current smokers. Smoking exacerbates the long-term damage caused by TB including fibrosis, bronchiectasis, and chronic obstructive pulmonary disease. “We hope h demonstration of how malnutrition and alcoholism are driving the TB epidemic in India will help local TB programs target resources to reduce the local burden of TB,” added Natasha Hochberg, Assistant Professor at the Boston University School of Medicine (BUSM) in the US.