Impact Of Centralized Nikshay On TB Notification And Data Completeness In Indigenous Tribes: A 21-Year Study

BACKGROUND: Indigenous tribes face a disproportionately high tuberculosis (TB) burden due to deep-rooted socioeconomic disadvantage, highlighting the need for strengthened, culturally sensitive control strategies. METHODS: We conducted a 21-year retrospective study (2005-2025) among tribal and neighboring non-tribal populations attending a tribal-serving hospital in Karnataka. Pre-Nikshay data were transcribed from paper registers, and post-Nikshay data were obtained from the digital system. We assessed negative binomial interrupted time-series regression model, data completeness, TB risk factors, and used multivariable logistic regression to identify determinants of poor treatment outcomes and household contact screening yield. RESULTS: We analyzed 1,512 TB cases (tribal = 1,021; non-tribal = 491). TB detection increased significantly over time, with a steeper rise among tribal populations (p<0.001). Nikshay implementation significantly improved data completeness (Wilcoxon W = 9900, p<0.001). Among tribal patients, males had higher odds of poor treatment outcome (aOR 2.81, 95% CI 1.70- 4.85; p<0.001). Diabetes (aOR 2.10, 95% CI 1.05- 4.03; p=0.029) was independently associated with poor treatment outcome. Among 503 index cases, 1,535 household contacts were identified and 1,161 (75.6%) screened; coverage was lower among tribal contacts (69.8% vs 87.2%; p<0.001). CONCLUSIONS: Nikshay strengthened TB surveillance and improved assessment of TB burden and risk factors in tribal communities.