Even as the COVID-19 pandemic derailed global efforts to curb Tuberculosis (TB), the government is set to launch a special door-to-door TB screening initiative on a "war footing", as only three years remain of its 2025 target to eradicate the deadly disease.

The initiative will be launched officially on March 24, globally observed as World TB Day. Under this initiative, over the next two to three weeks, health workers will be visiting the vulnerable population that is potentially exposed to the infection and check for typical symptoms of TB, such as persistent cough, chest pain, weight loss and fatigue.

Those found to be symptomatic will be tested using TrueNAT, an indigenous portable, battery-operated, Internet of Thing-enabled RT-PCR platform developed and manufactured by Goa-based Molbio Diagnostics. Globally, TB is known to be the biggest cause of death due to an infectious disease, and India contributes to over 30 per cent of the global TB burden.

In March last year, an analysis by the Health Ministry had notified that COVID brought down TB detection by 25 per cent in India in 2020. Tuberculosis notifications were reduced to 18.02 lakh in 2020 from 24.04 lakh in 2019 due to the lockdown and diversion of resources, the Health Ministry had said.

Similarly, the Global TB report 2021 released by the World Health Organization (WHO) showed that India accounted for 41 per cent of the global dip in reporting TB cases during the pandemic.

"The impact of COVID has been very significant on TB, because from March 2020 for at least about eight to nine months, absolutely zero TB testing took place, whether at public or at private centres. The same pattern followed during the second wave also," Sriram Natarajan, CEO, Founder & Director, Molbio Diagnostics, told IANS.

"For the last one-and-a-half years, there's hardly been much TB testing. From about 12 per cent, the case positivity rate has gone up to 35-40 per cent. We have gone back by at least about five to seven years," he added. Even after the gap brought in by COVID, Natrajan is optimistic that India can eradicate TB by 2025.

"We still have three years to quickly scale up the operations. It is definitely possible to reduce the burden dramatically. That's why the government is taking the initiative on a war footing to scale up testing in the country," he said.

The indigenously developed Truenat technology was also endorsed by the World Health Organization in 2020 as the world's first point-of-care rapid molecular diagnostic platform for the diagnosis of TB and multidrug resistance.

Truenat is completely independent of the laboratory and is an affordable machine. Besides TB, it can test for nearly 30 diseases, including COVID-19, Hepatitis, HIV, Dengue, Malaria and results take less than an hour to come. Truenat machines are also telemedicine capable and can be linked to Cloud and the reporting can be done on a real-time basis, Natarajan said.

Truenat machines are being deployed at the sub-district level in the remotest corners across the country. Over 3,500 community and home healthcare, as well as primary healthcare centres, have been equipped with Truenat devices under the National Tuberculosis Elimination Programme (NTEP) for first-line testing of TB in suspected patients.

The ongoing expansion in the rollout of this technology across the healthcare chain will ensure that patients will not have to travel long distances and wait long hours to access an early and accurate diagnosis. Meanwhile, Natarajan said that the next phase of the campaign includes end-to-end active case finding, which will be done via mobile vans.

Mobile vans will be deployed at the hotspot areas with X-Ray and PCR systems in them and the testing will be done by X-Ray machine instead of asking questions. "X-ray is quite a sensitive tool in identifying TB and can also give false positives. For confirmation of the disease, further, it will be run through PCR within and in about 2- hours the results will be out," he told IANS.

"This is not part of the campaign right now, but eventually will be introduced in the campaign. We have 10 mobile vans in Andhra Pradesh and five in Gujarat. We are getting into a larger kind of capacity building to make sure we have enough and adequate vans to be operationalised," he added.

Besides India, the campaign will also be run in 13 other countries by the USAID through a programme called the New Tools project, which will be scaled to more than 25 countries in the coming year, Natarajan told IANS.