Tamil Nadu has achieved a significant milestone in public health by recording at least a 38 per cent reduction in its tuberculosis death rate across quarterly diagnosis cohorts between July 2024 and December 2025. This achievement comes under a statewide initiative known as the Tamil Nadu Kasanoi Erappila Thittam, which aims to make the state entirely free of tuberculosis deaths. Developed jointly by the ICMR National Institute of Epidemiology and the Tamil Nadu State TB Cell, the monitoring and evaluation framework behind this success has been published as a practice paper in BMJ Global Health. The programme, recognized as India's first statewide differentiated TB care initiative, covers adults aged 15 years and above diagnosed with drug-sensitive tuberculosis in public health facilities across the region. Under this protocol, patients undergo immediate clinical assessment at the time of diagnosis using five specific parameters, which include body mass index, pedal oedema, respiratory rate, oxygen saturation, and physical capability to stand without external support. Patients identified as severely ill—such as those suffering from profound undernutrition, respiratory insufficiency, or extremely poor physical performance—are immediately prioritised for formal hospital referral and inpatient care. While the initiative successfully reduced death rates from an initial baseline of 6.3 per cent down to between 3.9 and 2.8 per cent in later cohorts, the study also uncovered critical challenges within the public health infrastructure. Specifically, systematic tracking and follow-up care for high-risk patients two months after hospital discharge remained problematic, with follow-up rates failing to exceed 35 per cent in any observed quarter. Researchers emphasize that despite these post-discharge tracking gaps, the core triaging framework offers a highly effective, replicable model for other high-burden states and resource-constrained healthcare regions worldwide. Fuente: The Hindu BusinessLine
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