Clearing the air: microcosting the carbon impact of drug-susceptible pulmonary TB treatment.

More than 10 million individuals develop active TB each year. The diagnosis and treatment of TB create greenhouse gas emissions, contributing to climate change. This study estimates the carbon footprint (CF) of successfully treating one person with drug-susceptible pulmonary TB (DS-PTB) in India.We defined the cascade of care for DS-PTB using national guidelines, interviews, and direct observation. We estimated the inputs for TB diagnosis and treatment in United States dollars, kilowatts per hour, and kilometres travelled; we converted them into carbon dioxide emissions equivalents (CO2e) using an appropriate calculator.The CF of diagnosing and treating one person with DS-PTB in India is 103.8 kg CO2e: 31.9% attributable to diagnosis and 68.1% to treatment. Emissions came primarily from first-line drugs (21.2%), hospitalisations (17.4%), and laboratory processes.We conservatively estimate that treating all persons with TB in India would produce at least 290,640 metric tonnes of CO2e per year, approximately the same emissions as 63,182 passenger cars in the United States. It is evident that one of India's leading public health challenges also contributes meaningfully to climate change..

A micro-costing analysis of nutritional support for persons with TB and their families in India.

Undernutrition is the leading risk factor for TB infection and death in India. We undertook a micro-costing analysis of a nutritional intervention for household contacts of people living with TB in Puducherry, India. We found that the total 6-month food cost for a family of four was USD4/day. We also identified several alternative regimens and cost-lowering strategies to encourage wider adoption of nutritional supplementation as a public health tool.

La sous-nutrition est le principal facteur de risque d'infection et de décès dus à la TB en Inde. Nous avons entrepris une analyse de micro-coût d'une intervention nutritionnelle destinée aux contacts familiaux des personnes atteintes de la TB à Puducherry, en Inde. Nous avons constaté que le coût total de la nourriture pendant 6 mois pour une famille de quatre personnes était de 4 USD par jour. Nous avons également identifié plusieurs régimes alternatifs et stratégies de réduction des coûts pour encourager une adoption plus large de la supplémentation nutritionnelle en tant qu'outil de santé publique.