“I want to do a small project in tuberculosis, which involves some service to the community. Could you please guide me?” asked my third-year MBBS student Siddharth. I readily agreed, happy to have pulled in one more into the bandwagon of my enthusiasm for tuberculosis and community care! Soon, his friends Anushri and Gayatri, who were also interested, became part of our team, and we developed a proposal to screen the population in three slums of our urban area for tuberculosis (TB) and follow up their care pathways.
We spoke to the TB diagnostic centre of the National Tuberculosis Elimination Programme (NTEP) in the area, regarding the activity, and they agreed to do the Truenat testing for the individuals we screened and identified to be at risk. Permission letters and ethical clearance were obtained from our college, and the trio set out into the field for screening.
They screened around 800 consenting individuals from the area using the 4-symptom questionnaire, which is routinely used for active case finding activities by NTEP (The programme expanded it to a 10-symptom questionnaire in September 2025 after our activity was over). They also carried out awareness sessions for the households on the symptoms of TB and the need for getting tested.
(Gayatri and Anushri during TB screening in the slum)
Going around the three slums on their scooty, hopping house-to-house, on holidays, they even faced the wrath of some very hostile family members who shouted at them for paying a visit!
But they continued, imbibing the good spirit of true community health work, with a smile on their faces. The team identified 4 individuals with presumptive TB and counselled them to go for testing at the NTEP centre with the referral slip we gave. It was planned to follow up with them after a week to know the test results or to know the reasons for not going for testing, and to motivate them to do testing.
(Swathi, Siddharth & Anushri during TB screening in the slum)
Now came the dreaded ‘Public health complication’, a routine occurrence in most of our field interventions- none of the four had gone for testing! While I was expecting this, the trio was disappointed. But they were not ready to give up. They enquired the reasons (which were indeed the most common ones- hesitancy to get tested, fear of stigmatization, loss of wages) and realized that persuading the presumptive TB individuals to go to a centre and give a sputum sample for testing was hard.
