Implementation of Triage Tool in Tamil Nadu for Tuberculosis (TB)

A five-question triage tool has been implemented in Tamil Nadu to reduce early TB deaths. This simple tool, requiring no laboratory tests, has shown significant results within half a year of its implementation.

Impact of the Triage Tool

• The tool led to a 20% statewide reduction in early TB deaths within the first two months of treatment initiation.
• Two-thirds of districts in the state reported a 20% to 30% reduction in total deaths in 2024.
• The initiative is being considered for national implementation following its success in Tamil Nadu.

Key Parameters of the Triage Tool

• Height and weight to calculate body mass index (BMI) for detecting undernutrition.
• Swelling of the leg assessed by pressing for 15 seconds.
• Respiratory rate per minute in a sitting position.
• Oxygen saturation measured with a pulse oximeter.
• Ability to stand without support.

Outcomes of the Initiative

Patients identified as severely ill are referred for comprehensive assessment and inpatient treatment. Immediate care significantly reduces death probability.

The Tamil Nadu-Kasanoi Erappila Thittam (TN-KET) showcases the feasibility and effectiveness of such differentiated care models, helping reduce early TB deaths.

National Programme Interventions

• Monetary nutritional support increased from Rs 500 to Rs 1,000, with the first three instalments provided at diagnosis.
• Despite policy changes, delays in support distribution were noted, affecting treatment outcomes.
• Recommendations include doubling monthly rations for those with severe undernutrition, yet not implemented nationally.