Beating TB with TN-KET

Syllabus areas:

GS II - Governance

GS III - Science & Technology

Tamil Nadu has witnessed a significant decline in tuberculosis (TB) deaths following the rollout of a novel initiative called Kasanoi Erappila Thittam (TN-KET) in 2022. According to a study published in the Indian Journal of Community Medicine, TB death rates dropped by 20% across the state within months of implementation, showing potential for national replication.

 What is TN-KET?

  • TN-KET stands for Kasanoi Erappila Thittam, which means "TB Death-Free Scheme" in Tamil.
  • It is a state-level initiative to reduce TB mortality through early diagnosis and differentiated patient care.
  • Rolled out in 2022 across Tamil Nadu, starting with three districts: Dharampuri, Karur, and Villupuram.

Impact of the Initiative

  • TB death rate reduced in key districts:
    • Dharampuri: 15.2% → 7.8%
    • Karur: 7.1% → 5.3%
    • Villupuram: 6.1% → 5.2%
  • 98% of patients diagnosed using the triage tool were examined the same day, and 98% of severely ill patients were hospitalized within 7 days.
  • Tamil Nadu saw a 20–30% drop in TB deaths in districts that implemented the model.

How does the triage tool work?

A simple, point-of-care bedside tool is used to assess the severity of a TB patient’s condition without lab tests.

  • Key parameters checked:
    • BMI (Body Mass Index): Patients with BMI < 14kg/m² are considered severely ill.
    • Leg swelling: Determined by pressing for 15 seconds.
    • Respiratory rate
    • Oxygen saturation (using a pulse oximeter)
  • Based on these, patients are classified as "severely ill" or not and prioritized for immediate hospitalization and lab tests.

What is a differentiated TB care model?

  • A strategy outlined in the National Tuberculosis Elimination Programme (NTEP, 2021).
  • Shifts from one-size-fits-all treatment to patient-centred care:
    • Takes into account age, weight, comorbidities, and medical history.
    • Customizes treatment based on severity and risk.
  • Helps identify and prioritize vulnerable and critically ill patients for rapid intervention.

Use of Technology and Data

  • Integration with TB Web Application (Nikshay platform).
  • Frontline workers record 14 patient parameters for centralized data-based analysis.
  • Enables faster diagnosis (within a day) and monitoring of patient outcomes.

Why is This Significant?

  • India holds the highest TB burden globally:
    • In 2023, it accounted for 26% of global TB cases and 28% of TB deaths.
  • TN-KET’s success proves that:
    • A simple triage tool and differentiated care can save lives.
    • Immediate inpatient care can reduce TB death probability by 1–4%.
  • Scalability potential: Can be replicated in other states to reduce India’s TB mortality significantly.