According to Dr. Kavita Vasudevan of the Indira Gandhi Medical College and Research Institute (IGMC&RI) in Puducherry, verbal autopsy is a scientific technique that can greatly help India in the fight against tuberculosis because it helps pinpoint the underlying causes of death brought on by the most deadly infection in the world.

She described how a verbal autopsy model can be used to better refer patients, find trends of TB treatment delays, and determine the causes of TB deaths.

“To effectively combat TB, a comprehensive strategy is required, which involves understanding the underlying causes of disease-related mortality, providing high-quality TB care through access to effective therapeutic medications, preventative techniques, and high-quality diagnostics. Determining the causes of tuberculosis mortality can yield important information on the elements that contribute to these deaths.

A verbal autopsy: what is it?

In a verbal autopsy, the deceased’s close family members or caretakers are questioned regarding the events and contributing factors to their death.

In order to determine the factors that contribute to TB patients’ death, this strategy combines quantitative and qualitative methods. Clinical records of TB deaths are being examined for the quantitative approach, while stakeholder interviews with National TB Elimination Programme (NTEP) personnel and the relatives of the deceased patients are being conducted for the qualitative component, Vasudevan explained.

It is particularly pertinent in cases where medical records do not provide strong evidence of the causes of fatalities.

For instance, questions concerning the deceased’s symptoms, medical history, length of hospital stay, treatment received, and circumstances at the time of death are posed to the deceased’s close family members or caretakers. Following the systematic collection of this data, medical professionals determine the most likely cause of death.

“Verbal autopsy provides insights into the patient as well as health system delays, social or financial challenges faced during the illness, perceptions of healthcare services, and barriers to accessing timely diagnosis and treatment,” Vasudevan stated.

Since 2001, the model has also been used to provide high-quality cause-of-death data as part of the government’s Sample Registration System.

Additionally, the All India Institute of Medical Sciences (AIIMS), New Delhi, created the “Mortality in India Established through Verbal Autopsy” (MINErVA) platform in 2017 in collaboration with state-level partners throughout India in order to fortify the country’s national mortality surveillance system.

In order to determine the cause of death and make the required modifications to streamline the program and improve service delivery mechanisms for preventing preventable deaths, the National Tuberculosis Elimination Programme (NTEP) requires a thorough verbal autopsy of deaths among TB patients.

After coronavirus disease, tuberculosis is the second most common infectious agent-related cause of mortality, surpassing HIV, and it ranks among the top ten causes of death globally. The prevalence of TB in India continues to be a serious public health concern. According to current estimates, there were 23 TB-related deaths for every lakh people in India, Vasudevan stated.

Reducing TB mortality worldwide by 90% by 2025 is one of the benchmarks set by the WHO End TB Strategy and the National Strategic Plan.

In order to better understand early symptoms, symptom duration, treatment initiation and interruptions, and the diagnostic procedure, the World Health Organization (WHO) has now recommended verbal autopsies as a crucial tool in the fight against tuberculosis.

Autopsy by verbal in Puducherry

According to Vasudevan, IGMC physicians are utilizing the scientific technique to look into the reasons behind 160 TB-related deaths that were reported in the UT in 2024 and to find issues that are related to both patients and the health system.

According to preliminary study, most TB deaths happen within seven days of a patient receiving a diagnosis, which suggests that patients are arriving at the hospital later than expected, Vasudevan added.

“A substantial portion of the patients who passed away were from Tamil Nadu’s surrounding districts. These patients frequently provide fictitious addresses or the addresses of their Puducherry relatives when they visit medical facilities in Puducherry to receive treatment, she continued.

According to Vasudevan, who is in charge of the initiative in Puducherry, the verbal autopsy will assist in identifying trends in treatment delays, determining the causes of TB deaths, and enhancing triage and referral systems.