Cost of TB care and equity in distribution of catastrophic TB care costs across income quintiles in India.

Background: Tuberculosis (TB) poses a significant social and economic burden to households of persons with TB (PwTB). Despite free diagnosis and care under the National TB Elimination Programme (NTEP), individuals often experience significant out-of-pocket expenditure and lost productivity, causing financial catastrophe. We estimated the costs incurred by the PwTB during TB care and identified the factors associated with the costs.

Bridging the "know-do" gap to improve active case finding for tuberculosis in India: A qualitative exploration into national tuberculosis elimination program staffs' perspectives.

Background: In 2022, India's national tuberculosis (TB) elimination program (NTEP) commissioned a national level evaluation of active case finding (ACF) for TB to guide evidence-based strategic planning. As part of this evaluation, based on secondary data analysis we observed that the quality of ACF was suboptimal in 2021. Hence, this study aimed to understand the enablers, barriers, and suggested solutions to improve ACF for TB in India from NTEP staff (provider) perspective.

"TB drug stock planning in advance is a futile activity" health system's perceived challenges and suggested solutions pertaining to Nikshay Aushadhi portal in central India.

Background: The National TB elimination programme (NTEP) is facilitating sub-national certification of "TB Free" status with benchmarks at every 20% reduction in incidence from the baseline of 2015. Drug consumption/sale is essential criteria to claim for the award. During the certification process in 10 districts of Madhya Pradesh in 2022, it was found that Nikshay Aushadhi (a web-based supply chain management portal) entries were incomplete or vacant in most of the districts and it was observed that quarterly drug requests were not sent using Nikshay Aushadhi.

Lessons Learned From a Peer-Supported Differentiated Care and Nutritional Supplementation for People With TB in a Southern Indian State.

Two critical components of patient support systems for people with TB are regular counseling and locally managed nutritional support. As part of an ongoing differentiated TB care initiative called Tamil Nadu Kasanoi Erappila Thittam (meaning TB death-free initiative in Tamil, TN-KET) to reduce TB deaths, adults with TB with very severe undernutrition, respiratory insufficiency, or poor performance status are identified at diagnosis (triage-positive) and prioritized for referral, comprehensive clinical assessment, and inpatient care. Between January and June 2023, in 6 districts, a pilot exercise was conducted in which trained TB survivors, known as TB champions, provided baseline counseling and additional counseling (if required) to triage-positive people with TB at diagnosis.

Barriers to engagement in the care cascade for tuberculosis disease in India: A systematic review of quantitative studies.

Background: India accounts for about one-quarter of people contracting tuberculosis (TB) disease annually and nearly one-third of TB deaths globally. Many Indians do not navigate all care cascade stages to receive TB treatment and achieve recurrence-free survival. Guided by a population/exposure/comparison/outcomes (PECO) framework, we report findings of a systematic review to identify factors contributing to unfavorable outcomes across each care cascade gap for TB disease in India.