Surge in TB Cases in India Linked to Pollution, Malnutrition, and Social Stigma

New Delhi: Tuberculosis remains one of the country’s leading causes of death, with recent trends linking the surge in infections to environmental, nutritional, and social factors.

According to the WHO Global TB Report 2023, India recorded 2.8 million new TB cases in 2022, marking a 13% increase compared to pre-pandemic levels. The disease claims approximately 340,000 Indian lives annually, equating to nearly 930 deaths per day.

Environmental experts have identified air pollution as a growing risk factor for TB. Studies, including one published in The Lancet Planetary Health (2022), show that prolonged exposure to PM2.5 fine particulate matter significantly raises the risk of TB infection. Research from Delhi and Mumbai—cities with some of the world's worst air quality—confirms that areas with poor air conditions report higher TB prevalence.

A 2024 study in BMC Public Health further emphasized that indoor air pollution contributes to 26% of TB cases. Experts like Dr. Akshay Budhraja, Senior Consultant at Aakash Healthcare, warn that pollution impairs lung health and immune function, activating latent TB and worsening outcomes for existing patients.

Malnutrition is another major driver of India’s TB crisis. A Lancet study (2022) found that 45% of Indian TB patients are undernourished, significantly weakening their immune systems and making them 3–4 times more susceptible to developing active TB.

“Undernutrition isn’t just a risk factor—it’s the fuel that drives TB,” says Dr. Neetu Jain, Pulmonologist at PSRI Hospital. She stresses the need to address food insecurity alongside TB care to break the infection cycle.

Social stigma continues to hinder early diagnosis and treatment. Fear of isolation, discrimination, or job loss compels many patients to hide symptoms and delay seeking care until the disease is severe. Dr. Manav Manchanda from Asian Hospital explains that some individuals only come forward when symptoms escalate to coughing blood, by which time treatment becomes more complicated.

India’s TB control strategy includes free sputum and molecular testing, 6–9 month drug regimens under the DOTS program, and financial support through the Nikshay Poshan Yojana, which offers ₹500 monthly to TB patients for nutritional support.

The BCG vaccine, given in infancy, provides protection against severe TB forms. However, rising cases of drug-resistant TB—1.5 lakh reported in 2022—pose a significant treatment challenge.

Raising public awareness is also critical. Education campaigns help promote early testing, reduce stigma, and ensure patients complete treatment to prevent resistance.

Doctors also warn about TB’s complications, especially tuberculous meningitis (TBM)—a severe neurological form that can cause brain damage, strokes, or hydrocephalus if not diagnosed in time.

“Incomplete treatment is a key concern,” says Dr. Sushrut Ganpule of Jupiter Hospital, highlighting that interrupted drug regimens often lead to resistance, making TB harder to cure and more deadly.

Despite persistent challenges, with stronger public health measures, environmental reforms, nutritional support, and stigma reduction, India can make significant strides toward controlling the TB epidemic.