title: Food assistance to tuberculosis patients: lessons from Afghanistan.
abstract: Poverty, food insecurity and poor nutrition in the population are important contributors to the burden of tuberculosis (TB). For poor and food-insecure individuals, accessing and successfully completing anti-tuberculosis treatment over an extended period of time is challenging. Food and nutritional support as an incentive and enabler is employed by national TB control programmes (NTPs) worldwide as a means to encourage treatment initiation and adherence and to improve the nutritional status of patients with TB. It also offers a safety net for food-insecure households affected by TB to mitigate the financial consequences of the disease. This paper reports on the primary lessons from the review of the World Food Programme's (WFP's) Food Assistance Programme for TB patients in Afghanistan. It aims to inform the design, implementation and scale-up of TB programmes in settings where food insecurity and malnutrition are prevalent. It also documents qualitative findings that suggest that patients, their families and providers viewed food support as an important asset and an essential element of the national TB control strategy. While the impact on treatment success or case detection could not be quantified, it is likely that the WFP intervention had a positive impact on the patients and their households, therefore contributing to the success of the DOTS-based NTP.
authors.affiliation: TB Modelling Group, TB Centre and Centre for the Mathematical Modelling of Infectious Diseases, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Pedrazzoli
authors.affiliation: TB Modelling Group, TB Centre and Centre for the Mathematical Modelling of Infectious Diseases, Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine (LSHTM), London, UK.
authors.forename: R M
authors.initials: RM
authors.lastname: Houben
authors.affiliation: World Food Programme (WFP) Country Office, San Salvador, El Salvador.
authors.forename: N
authors.initials: N
authors.lastname: Grede
authors.affiliation: Nutrition Division, WFP, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: de Pee
authors.affiliation: Faculty of Epidemiology and Population Health, LSHTM, London, UK.
authors.forename: D
authors.initials: D
authors.lastname: Boccia
keywords: TB; enablers; nutrition; transfers