The Swasthya Nagaram is an Urban End TB initiative designed towards accelerating the progress toward TB elimination. The key intervention Population-level Systematic Active Screening for TB Disease.
While implementing Population-level Systematic Active Screening for TB Disease, various tools and models for screening will be evaluated as a pragmatic randomized controlled trial. The evaluation will focus on identifying the most cost effective population level systematic screening approach for urban areas. Two key methods under evaluation are the use of Ai enabled ultra-portable chest X-ray machines with CAD, and high-throughput low-cost molecular tests. Other associated tools that will also be evaluated would be targeted screening of vulnerable groups, Cough Ai, sample collection transportation systems.
The three-year project is being implemented under the stewardship of urban local bodies (municipal corporations of Peerzadiguda, Boduppal and Pocharam) with support from NTEP, and State of Telangana. Three urban local bodies have declared their commitment to End TB in their jurisdiction and the project was officially launched on July 23, 2024, in the presence of all stakeholders.
Aim: Among the adult population (aged ≥18 years) in clusters implementing three different screening approaches [community-wide screening with upfront chest X-ray (Arm-1), community-wide screening with low-cost molecular screening test (Arm-2) and routine programmatic care relying largely on passive case finding (arm 3)], annually over two years (2025-2026) in three municipal corporations of the Greater Hyderabad Municipal Corporation,
Primary objective: to Assess the effectiveness by comparing the prevalence of bacteriologically-confirmed pulmonary TB in Arm-1 and Arm-2 with Arm-3 in 2027 (third year of the project)
Secondary objectives:
- to assess the coverage of the screening algorithm and explore the facilitators, barriers, and adaptations made to improve the uptake of screening in Arm-1 and Arm-2.
- the total cost of implementing Arm-1 and Arm-2 and incremental cost-effectiveness of Arm-1 and Arm-2 for preventing one additional TB case compared to Arm-3