Differentiated Care Approach to Fight TB, Tamil Nadu Background
- Triaging of TB patients at diagnosis based on severity was piloted in Karnataka, where it was found that at least 30-40% of the deaths can be prevented if triaging and appropriate care is provided to people who have severe illness.
- Karnataka triaging data showed that people with TB with one of these three conditions at diagnosis (very severe undernutrition, respiratory insufficiency, or inability to stand without support) are 2.4 times more likely to die.
- After pilot study in Karnataka, Tamil Nadu has pioneered an initiative across the State to reduce the mortality rate among people with tuberculosis.
- The initiative is named TN-KET (Tamil Nadu Kasanoi Erappila Thittam, meaning TB death-free project).
- Start: TN-KET was started in April 2022 in 2,500-odd public healthcare facilities that diagnosed TB in 30 districts. It has already achieved significant reduction in the number of early TB deaths.
- Idea behind initiative: The initiative is based on the ‘Differentiated TB Care’ aimed at assessing whether people with TB need ambulatory care or admission in a health facility to manage severe illness at the time of diagnosis.
- Chennai-based National Institute of Epidemiology (ICMR-NIE) found that preliminary assessment (triaging) of patients based on just three conditions was feasible for quick identification at diagnosis.
- The strategy: Three condition strategy identifies people with severe TB illness needing immediate care and admits them to a healthcare facility on the same day of diagnosis, thus vastly cutting down the delay and increasing the chances of saving lives.
- The State has earmarked 900 beds for people with TB who are severely ill. A detailed care guide for several conditions/diseases has been prepared to help doctors to treat severely ill patients.
- Success: The TN-KET initiative has achieved the initial target of 80% triaging of patients, 80% referral, comprehensive assessment and confirmation of severe illness, and 80% admission among confirmed.
- Future actions: The focus this year is on improving the quality of inpatient care for severely ill adults with the ultimate goal of further reducing TB mortality.