Tuberculosis (TB) has long been identified as a disease predominantly affecting impoverished populations; however, most TB research fails to meaningfully quantify poverty levels among its subjects. A recent review published in BMC Global and Public Health critically evaluates current methods used to assess socioeconomic status within TB studies, revealing significant limitations in these approaches.
Conducted by an international team of researchers from Boston University Chobanian & Avedisian School of Medicine, Brown University, and Oxford University, the study investigates various poverty measurement techniques employed in TB research. These include income-based measures, wealth indices, and multidimensional poverty indices (MPIs). The authors uncovered that many commonly utilized tools fall short in capturing essential aspects of deprivation relevant to TB risk factors and treatment outcomes.
“Poverty is not merely a background factor—it’s integral to understanding who develops TB and who faces challenges during treatment,” notes corresponding author Pranay Sinha, MD, assistant professor of medicine at Boston University. “However, numerous TB studies rely on outdated or oversimplified measures of socioeconomic status, which hampers our ability to learn from these studies and implement effective interventions.”
As part of the review process, researchers also examined how frequently observational TB studies incorporate poverty measurements. They found that in the 100 most recently published observational TB studies, nearly 70% did not include any measure of socioeconomic status.
“The lack of measurement can result in misinterpretations of TB risk factors and policies that fail to reach those who are most vulnerable,” says Chelsie Cintron, MPH, a co-first author and third-year doctoral student at Brown University. “If we do not accurately assess poverty levels, our efforts will be less effective.
The authors argue for the adoption of more refined tools like the global multidimensional poverty index (MPI), which has been developed and successfully applied in various contexts by Jakob Dirksen MSc, MPP—a research and policy officer at Oxford Poverty & Human Development Initiative. Such tools could help create targeted interventions and strengthen policy recommendations.
This comprehensive review was supported by several organizations including the National Institutes of Health, the Warren Alpert Foundation, the Burroughs Wellcome Fund/American Society for Tropical Medicine and Hygiene, and India’s Department of Biotechnology and Indian Council of Medical Research.
