Effect of the '100 days TB elimination campaign' on TB notification in Maharashtra

The 100-Day TB Elimination Campaign is a nationwide initiative launched by the Government of India to accelerate the progress of tuberculosis (TB) elimination by 2025, by emphasizing intensified case detection, early diagnosis, targeted screening, and improved patient care through nutritional and financial support.

ology: A quasi-experimental Difference-in-Differences (DID) approach was used to assess the effect of the 100-day TB Elimination campaign in Maharashtra, by comparing 53 campaign districts with 27 no-campaign districts during the campaign period (7th December to 17th March 2024-25) and for the 100 days in the previous year; the pre-campaign period (7th December to 17th March 2023-24) using the data accessed from the NIKSHAY portal.

While there was a 10 % decline in the TB notification in no-campaign districts, 1 % decline was noted in the campaign districts. The Difference-in-Differences analysis indicated the relative change in TB notification rate in the campaign districts was 10 % higher compared to no-campaign districts [DID IRR = 1.10, 95 % CI (1.03-1.17), p = 0.003]. Compared to no-campaign districts, the relative change in the TB notification rates was higher in campaign districts in rural setup [DID IRR-1.21, 95 % CI (1.11-1.32), p < 0.001] and in the public sector [DID IRR-1.17, 95 % CI (1.06-1.29), p = 0.001]. There was no significant impact of the 100-day campaign in the urban set-up [DID IRR = 0.95, 95 % CI (0.89-1.02); p = 0.152] and private health care services DID IRR = 0.97; 95 % CI (0.90-1.03); p = 0.313).

The findings of the present study suggest that the campaign helped mitigate a larger decline or stabilize TB notification rates in the campaign districts. A significant positive effect was observed in campaign districts in rural areas and within the public health sector, where a differential increase in TB notifications was recorded. These findings highlight the effectiveness of a targeted, community-based intervention in sustaining and improving TB surveillance and care, especially in vulnerable populations.