State-wide health systems strengthening initiatives for systematic tuberculosis passive case finding under programmatic settings in Haryana-Early implementation findings Article Swipe

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Hitesh Verma , Akash Ranjan Singh , Soundappan Kathirvel , Sandhya Gupta , Prabahar Ravichandran , S. Shanmugasundaram , Kedar Mehta , Kuldeep Singh ·

YOU? · · 2025 · Open Access · · DOI: https://doi.org/10.1101/2025.10.21.25338493

SETTINGS Systematic tuberculosis (TB) passive case finding initiative in Haryana, a high-TB burden state in north India that has an annual shortfall of presumptive TB examinations. OBJECTIVE To compare the changes in enrolling persons with presumptive TB in public-sector peripheral health institutions (PHIs) between July–September (before) and October–December 2024 (during initiative). DESIGN In this quasi-experimental (before and during) study design, a multi-pronged health systems strengthening initiative was implemented state-wide: i) enrollment of PHIs below primary health centre level in Ni-kshay (web-based TB information management system), ii) identification of a nodal person from each PHI-without TB diagnosis centre (TDC) for enrolling presumptive TB in Ni-kshay and iii) identification of community volunteers for transport of sputum to TDCs. RESULTS The enrolment of over 10 presumptive TB at PHIs with TDC remained at 87%, while it increased from 51% to 63% in non-TDC PHIs. The mean number of sputum transport increased from 12 to 22 per non-TDC PHI. The presumptive TB enrolment rate increased from 1020 to 1660 per 100,000 population. CONCLUSION Early implementation findings are encouraging. We intend to sustain this in 2025 with additional interventions, culminating in early diagnosis and reducing the missing TB.

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Landing Page: https://doi.org/10.1101/2025.10.21.25338493
PDF: https://www.medrxiv.org/content/medrxiv/early/2025/10/23/2025.10.21.25338493.full.pdf
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DOI: https://doi.org/10.1101/2025.10.21.25338493

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Title: State-wide health systems strengthening initiatives for systematic tuberculosis passive case finding under programmatic settings in Haryana-Early implementation findings

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Publication year: 2025

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Authors: Hitesh Verma, Akash Ranjan Singh, Soundappan Kathirvel, Sandhya Gupta, Prabahar Ravichandran, S. Shanmugasundaram, Kedar Mehta, Kuldeep Singh

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Landing page: https://doi.org/10.1101/2025.10.21.25338493

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