Puducherry first to screen TB patients under Family Adoption Programme

Puducherry has become the first in the country to screen tuberculosis (TB) patients under the Family Adoption Programme, or FAP, which entails MBBS students adopting families to monitor their health conditions and give them consultation.

The National Medical Commission had in 2022 mandated the FAP as a part of the Competency Based Medical Education curriculum, requiring each medical student to adopt three to five families, once he or she joins the MBBS course.

''During their routine visits to adopted families, students screen the members for symptoms suggestive of tuberculosis and help them with both diagnosis of the disease and treatment,'' said Dr C Venkatesh, State TB Officer of Puducherry.

The student follows up with the patient till the successful completion of a full course of anti-tubercular therapy, he said, adding that Puducherry, a Union Territory, has become the first in the country to include screening for TB patients under the programme.

The FAP's objectives include understanding community dynamics, assessing health needs of its members, and generating data to inform and support evidence-based practices.

Case finding in TB control programmes has been passive for decades, and this being a patient-initiated activity, has its own limitation, Dr Venkatesh said.

Contrarily, experts now recommend active case finding which is a provider-initiated activity. Here risk groups are approached and identified, thus early diagnosis and treatment initiation are possible, he said.

''Medical colleges of Puducherry have utilised the opportunity of Family Adoption Programme, to tap these medical students as a resource to screen the adopted family members for tuberculosis,'' he said.

During their routine visits to allotted families, students screen the members for symptoms suggestive of TB and use a novel tool to assess the vulnerability status of the members for TB.

The approach allows even the asymptomatic individuals, who are identified as moderate to high risk of developing TB, to become eligible for investigations, Dr Venkatesh said.

''Once diagnosed as positive for TB, the student accompanies the patient to the hospital and helps in linking the patient to the TB programme,'' he said.

The medical student provides counselling to the patient, as well as the family members, regarding respiratory hygiene, sputum disposal methods, role of nutrition, clearing myths regarding stigma and discrimination against TB patients.

In addition, the student conducts contact tracing among the other family members and helps start the TB preventive therapy to eligible family members, Dr Venkatesh said.

The student periodically screens the members of the allotted families for three years and ensures those with high risk are identified earlier for diagnosis.

All these would not have been possible without the support of the state by provision of consumables, logistics, sputum transport, diagnostic and treatment services, Dr Venkatesh said. The first-of-a-kind low cost model has been well received in scientific forums for its scalable nature and use of medical students as a manpower for screening for tuberculosis, in regions where there is scarcity of resources, Dr Venkatesh.

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