More people die from Tuberculosis (TB) than any other infectious disease worldwide. In India, two people die from TB every three minutes, and the country alone makes up more than one fifth of the world’s TB cases
India’s Ministry of Health and Family Welfare (MoHFW) has set the ambitious goal of eliminating TB by 2025, five years ahead of the Sustainable Development Goals
Key to this mission is active case finding (ACF). ACF is the TB surveillance method that specifically targets high risk populations, leading to an increase in TB case detection, higher uptake of treatment, and a subsequent reduction in further TB transmission, among other benefits. Active case finding relies on household visits and specimen collection from presumptive TB cases
ACF is particularly important in Rajasthan, where Khushi Baby operates. Compared to the national average, Rajasthan has a significantly higher TB prevalence of 432 per 100,000 people and a total of 19,422 notified cases. ~37% of people are living in social vulnerability, and subsequently are at a higher risk for TB
Although ACF is integral to TB response in Rajasthan, a recent evaluation shows that TB ACF efforts in Rajasthan are not optimal. Positive cases are easily missed when TB surveillance is not prioritized amongst high risk communities. For example, in contrast to ACF efforts, the TB-free survey is implemented in the general population and in relatively well to do villages as per the ‘TB Mukt Gram Panchayat’ Abhiyaan (TB-free villages initiative). This surveillance method can lead to fewer positive TB cases identified in comparison to ACF efforts
There is an urgent need to implement TB ACF as per guidelines at scale and with optimal quality to meet the national goal of ending TB by 2025
Khushi Baby plays a key role in ACF in Rajasthan, as the technical partner to the state’s MoHFW. Our Community Health Integrated Platform (CHIP) has a TB ACF module which has been used by community health workers in Rajasthan to digitally track the last four state-wide TB ACF activities since 2022, facilitating screening for over 17 million people. The multimorbidity management feature and the Digital Health Census allows the MoHFW to understand the baseline health status of the entire rural population to identify high-risk communities and implement quality-control linked ACF
Partnerships are key to Khushi Baby’s approach to expanding scale and quality or ACF. We are committed to integrating machine learning and innovative AI solutions for targeted ACF in partnership with Rajasthan’s MoHFW, and we are collaborating with Wadhwani AI to scale the TB Cough Stratification tool across Rajasthan. In addition, we are working with ICMR-National Institute of Epidemiology to conduct implementation research and improve ACF drives per cycle. Read more about our partnership here
Moving forward, we will continue to strengthen CHIP as an ACF tool. CHWs will use CHIP to conduct screenings for socio-economic and health risk factors for TB, and during ACF drives, CHIP will generate a line-list of individuals at highest risk for priority screening. This methodology ensures comprehensive care and counseling in a single visit, with automated follow-ups for multimorbidity management
