MUMBAI: A digital calculator that can predict a tuberculosis (TB) patient’s risk of death awaited a national rollout for several months, even after a branch of the Indian Council of Medical Research (ICMR) recommended its inclusion in India’s TB elimination programme. The tool reduced total TB deaths by 20% to 30% in 2024 in its home state of Tamil Nadu. Across the country, more than three lakh people die of TB every year. Of these, between 1,000 and 2,000 deaths occur in Mumbai, the highest in Maharashtra, where a few thousand die of TB annually. The city reports an estimated 5,000 drug-resistant cases every year.
The web-based calculator, called ‘TB SeWA’ (Severe TB Web Application), is currently specific to Tamil Nadu. After waiting for the Central TB Division to act for several months, ICMR-NIE last month announced on X (formerly Twitter) that it would release its death prediction calculator as open-for-all in the public domain. “Contribution of Tamil Nadu Kasanoi Erappila Thittam (Tamil Nadu Tuberculosis Death-Free Project) to India,” it said.A senior doctor from ICMR’s National Institute of Epidemiology (NIE) said that for patients with severe illness, most early deaths happen within the first two months. “If you need to save them, their cases must be treated as emergencies, with immediate triage.”Tamil Nadu started this model in 2022 as a pen-and-paper system to detect severe illness. Trained community health workers identified a severe TB case using five simple checks. These include whether a person is too weak to stand, has low oxygen levels on a finger monitor, is dangerously thin, has swollen feet, or is breathing too fast.The model showed results. The state saw a 20% dip in early TB deaths in the first six months of its launch and 10% in overall deaths. A further reduction in total deaths by 20-30% was seen in 2024nIn July last year, ICMR added another feature and took the model online: along with severe illness, the risk of death could now be predicted using the five indicators.For patients falling within these indicators, their estimated mortality risk ranges from 10-50%. They are then prioritised for treatment accordingly, reducing their risk of dying by 1-4%.An official from the Central TB Division told TOI it “considered” the triaging model and that the national programme is “all-inclusive”.
