A Jeyakumar, S Kalaiselvi, D Nair, R Vijayaprabha, D Kabir, J M Melfha, T Bhatnagar, R Srinivasan, K Gayathri, K Boopathi, R S Vaman, V Rajan, S Shanmugasundaram, A Frederick, H D Shewade
{"title":"分类审计在印度泰米尔纳德邦正在进行的减少死亡的差异化结核病治疗倡议中的作用。","authors":"A Jeyakumar, S Kalaiselvi, D Nair, R Vijayaprabha, D Kabir, J M Melfha, T Bhatnagar, R Srinivasan, K Gayathri, K Boopathi, R S Vaman, V Rajan, S Shanmugasundaram, A Frederick, H D Shewade","doi":"10.5588/pha.25.0015","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>In the ongoing India's first state-wide differentiated TB care programme in Tamil Nadu (TN-KET), adults diagnosed with drug-sensitive TB at public facilities undergo triage. The adults with severe undernutrition, respiratory insufficiency, or poor performance status are prioritised for comprehensive assessment and inpatient care. Although the programme met triage coverage targets, 11 districts failed to achieve the goal of a 30% reduction in TB death rates. This study compares aggregate triage coverage with actual coverage and evaluates the quality of programme-reported triaging data against an investigator-led audit (repeat assessments in the field) within a few weeks of diagnosis.</p><p><strong>Design: </strong>An ecological study using routine programme data (April 2022-June 2024) was conducted for the first objective, and a cross-sectional analytical study with primary and secondary data (August 2024-February 2025) was performed for the triage audit.</p><p><strong>Results: </strong>Among 48,905 adults with drug-sensitive TB notified, the true triage coverage was 84% against the reported triage coverage of 113%. The triage audit showed 35.7% were triage-positive, compared with 27.6% through TB SeWA (Severe TB Web Application). The mean weight and body mass index from the audit were 0.82 kg and 0.63 kg/m<sup>2</sup> lower than TB SeWA data, and oedema was unassessed in 65% of the adults with TB.</p><p><strong>Conclusion: </strong>The districts need to address inadequate triage coverage and suboptimal quality of triaging.</p>","PeriodicalId":46239,"journal":{"name":"Public Health Action","volume":"15 3","pages":"118-123"},"PeriodicalIF":1.6000,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421824/pdf/","citationCount":"0","resultStr":"{\"title\":\"Role of triage audit in an ongoing differentiated TB care initiative to reduce deaths in Tamil Nadu, India.\",\"authors\":\"A Jeyakumar, S Kalaiselvi, D Nair, R Vijayaprabha, D Kabir, J M Melfha, T Bhatnagar, R Srinivasan, K Gayathri, K Boopathi, R S Vaman, V Rajan, S Shanmugasundaram, A Frederick, H D Shewade\",\"doi\":\"10.5588/pha.25.0015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>In the ongoing India's first state-wide differentiated TB care programme in Tamil Nadu (TN-KET), adults diagnosed with drug-sensitive TB at public facilities undergo triage. The adults with severe undernutrition, respiratory insufficiency, or poor performance status are prioritised for comprehensive assessment and inpatient care. Although the programme met triage coverage targets, 11 districts failed to achieve the goal of a 30% reduction in TB death rates. This study compares aggregate triage coverage with actual coverage and evaluates the quality of programme-reported triaging data against an investigator-led audit (repeat assessments in the field) within a few weeks of diagnosis.</p><p><strong>Design: </strong>An ecological study using routine programme data (April 2022-June 2024) was conducted for the first objective, and a cross-sectional analytical study with primary and secondary data (August 2024-February 2025) was performed for the triage audit.</p><p><strong>Results: </strong>Among 48,905 adults with drug-sensitive TB notified, the true triage coverage was 84% against the reported triage coverage of 113%. The triage audit showed 35.7% were triage-positive, compared with 27.6% through TB SeWA (Severe TB Web Application). The mean weight and body mass index from the audit were 0.82 kg and 0.63 kg/m<sup>2</sup> lower than TB SeWA data, and oedema was unassessed in 65% of the adults with TB.</p><p><strong>Conclusion: </strong>The districts need to address inadequate triage coverage and suboptimal quality of triaging.</p>\",\"PeriodicalId\":46239,\"journal\":{\"name\":\"Public Health Action\",\"volume\":\"15 3\",\"pages\":\"118-123\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2025-09-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421824/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Public Health Action\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.5588/pha.25.0015\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/9/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"RESPIRATORY SYSTEM\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Public Health Action","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.5588/pha.25.0015","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/9/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
Role of triage audit in an ongoing differentiated TB care initiative to reduce deaths in Tamil Nadu, India.
Objective: In the ongoing India's first state-wide differentiated TB care programme in Tamil Nadu (TN-KET), adults diagnosed with drug-sensitive TB at public facilities undergo triage. The adults with severe undernutrition, respiratory insufficiency, or poor performance status are prioritised for comprehensive assessment and inpatient care. Although the programme met triage coverage targets, 11 districts failed to achieve the goal of a 30% reduction in TB death rates. This study compares aggregate triage coverage with actual coverage and evaluates the quality of programme-reported triaging data against an investigator-led audit (repeat assessments in the field) within a few weeks of diagnosis.
Design: An ecological study using routine programme data (April 2022-June 2024) was conducted for the first objective, and a cross-sectional analytical study with primary and secondary data (August 2024-February 2025) was performed for the triage audit.
Results: Among 48,905 adults with drug-sensitive TB notified, the true triage coverage was 84% against the reported triage coverage of 113%. The triage audit showed 35.7% were triage-positive, compared with 27.6% through TB SeWA (Severe TB Web Application). The mean weight and body mass index from the audit were 0.82 kg and 0.63 kg/m2 lower than TB SeWA data, and oedema was unassessed in 65% of the adults with TB.
Conclusion: The districts need to address inadequate triage coverage and suboptimal quality of triaging.
期刊介绍：
Launched on 1 May 2011, Public Health Action (PHA) is an official publication of the International Union Against Tuberculosis and Lung Disease (The Union). It is an open access, online journal available world-wide to physicians, health workers, researchers, professors, students and decision-makers, including public health centres, medical, university and pharmaceutical libraries, hospitals, clinics, foundations and institutions. PHA is a peer-reviewed scholarly journal that actively encourages, communicates and reports new knowledge, dialogue and controversy in health systems and services for people in vulnerable and resource-limited communities — all topics that reflect the mission of The Union, Health solutions for the poor.
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