A Framework for Field Implementation for Tuberculosis Screening in India: Lessons from the 100 Days TB Campaign in Jharkhand, India

Abstract

general health system, expanding symptom profiles, and applying a structured vulnerability mapping exercise to

reach individuals at higher risk. However, the implementation across districts greatly differs, with consequences of

variable quality in screenings, fragmentary diagnostic pathways, and delays in monitoring systems. These then

reduce sensitivity at each step of the screening cascade, with implications for campaign cost-effectiveness.

Experiences from the 2024-25 implementation in tribal districts of Jharkhand highlight operational challenges; yet,

simultaneously offer a number of practical lessons on how TB screening could be strengthened without

overwhelming frontline workers or the health system. This paper outlines an implementation framework that

standardises vulnerability and symptom assessment, strengthens the use of X-ray and NAAT as first-line diagnostic

tools, and transitions to real-time, individual-level monitoring systems. It is expected that the screening yield will

increase, diagnostic efficiency will improve, and intensive campaigns will eventually translate into meaningful case

detection in vulnerable populations