Understanding Tamil Nadu KET Initiative for TB

TAMIL NADU KASANOI ERAPPILA THITTAM (TN-KET): A TB DEATH-FREE INITIATIVE

1. What is the Tamil Nadu KET Initiative?

The Tamil Nadu Kasanoi Erappila Thittam (TN-KET) is a tuberculosis death-free initiative launched in 2022. It aims to identify severe TB cases early and ensure timely referral for treatment through a simple, triage-based approach.

2. What is triage?

Triage is a process used by healthcare workers to quickly assess patients and determine the urgency of medical care required. It helps prioritize patients who need immediate attention and reduces the chances of treatment delay.

In the TN-KET programme, triage is performed using a paper-based tool that records key health indicators to identify high-risk TB patients efficiently.

3. What has been its impact so far?

According to the Indian Journal of Community Medicine (2023), TN-KET has significantly reduced TB deaths between 2022 and 2023:

• Dharmapuri: Death rate dropped from 12.5% to 7.8%
• Karur: 7.1% to 5.3%
• Villupuram: 6.1% to 5.2%

Overall, early TB deaths fell by 20% across two-thirds of districts. Notably, 98% of TB deaths occurred among patients identified as “severe” through the triage system, confirming its accuracy.

4. How does the triage system work?

The triage tool, designed for use by field health workers, records six to seven simple health parameters within 15 seconds to assess disease severity:

• Height and weight (to calculate BMI and identify malnutrition)
• Swelling in legs
• Respiratory rate
• Pulse oximeter reading (oxygen saturation)
• Ability to stand or walk
• Red flag if BMI is below 14 kg/m² or if the patient is unable to stand

Patients with poor health scores are marked as “severe TB” and referred immediately for hospital-based care and nutritional support.

5. How is this model different?

TN-KET is part of India’s differentiated TB care model under the National TB Elimination Programme (NTEP), launched in 2021. It provides personalized treatment based on:

• Clinical history and disease severity
• BMI and oxygen levels
• Physical condition and risk category

This model ensures that critically ill patients receive prompt, prioritized treatment and continuous follow-up, improving survival rates.

6. Why is this important for India?

• India accounts for 26% of global TB cases and 29% of global TB deaths (Global TB Report 2023).
• In 2023, over 28 lakh TB cases were reported in India.
• The TN-KET model shows how simple, low-cost innovations can save lives and reduce TB mortality.

7. What are the broader implications?

• The triage tool can be replicated nationwide as a scalable model.
• Tamil Nadu has also launched the Severe TB Web Application to digitally track high-risk patients.
• The initiative emphasizes early detection and rapid response at the grassroots level.

FAQs

1. What is the full form of TN-KET?

Tamil Nadu Kasanoi Erappila Thittam — meaning “TB Death-Free Programme.”

2. What does triage mean in simple terms?

Triage means quickly sorting patients to determine who needs urgent medical attention first.

3. Why is triage helpful for TB?

It enables health workers to identify severely ill TB patients early and minimize delays in starting life-saving treatment.

4. Is the triage tool high-tech?

No. The TN-KET triage tool is paper-based, easy to use, and requires minimal training.

5. Can other states adopt this model?

Yes. The TN-KET approach is cost-effective, scalable, and impactful, making it suitable for adoption by other states across India.