This tool in Tamil Nadu can predict deaths from tuberculosis
What's the story
In a major development, Tamil Nadu has become the first Indian state to implement a predictive model for tuberculosis (TB) deaths. The innovative tool, developed by the Indian Council of Medical Research's National Institute of Epidemiology, was integrated into the existing state-wide application, TB SeWA. The move is aimed at reducing mortality rates among adults suffering from TB by expediting hospital admissions for severely ill patients.
Application
How the TB SeWA app works
TB SeWA, or Severe TB Web Application, has been in use since 2022 as part of Tamil Nadu's differentiated care model initiative. Under this system, healthcare workers screen all newly diagnosed adults with TB for signs of severe undernutrition, respiratory distress, or poor physical condition using five key variables. These include the body mass index (BMI), pedal edema (swelling of the feet and ankles), respiratory rate, oxygen saturation levels, and the ability to stand without support.
Enhanced functionality
Predictive model displays probability of death
The new feature added to TB SeWA goes a step further by predicting and displaying the probability of death for adults with TB. This objective risk percentage is intended to eliminate any subjective interpretation of severity, and prompt frontline staff to take immediate action for hospital admission. The predicted probability of death varies between 'severely ill' and 'not severely ill' patients, ranging from 10% to as high as 50%, depending on how many conditions are present.
Model development
Model developed using data from 56,000 patients
The predictive death model was developed using data from almost 56,000 TB patients diagnosed in public health facilities across the state between July 2022 and June 2023. All 2,800 public health facilities in TN currently use the TB SeWA application along with a paper-based triage tool. "Tamil Nadu is so far the only state in India to systematically record and use five triage variables to guide patient management," said Dr Asha Frederick, State TB Officer of Tamil Nadu.