Tuberculosis Triage: How Screening Flags Who Needs Referral

India carries the world's largest tuberculosis burden, and a large share of cases go undiagnosed for too long. A lot of the delay is not about the test that confirms TB — it is about identifying who should be tested in the first place. That earlier step, sorting the people who need proper TB testing from those who probably don't, is called triage. It is worth understanding clearly, because it is easy to overclaim and we want to be exact about what screening can and cannot do here.

Triage is not diagnosis

Let us draw the line sharply, because it is the most important thing in this post. Diagnosing tuberculosis requires specific tests — sputum examination, molecular tests like rapid nucleic acid amplification, sometimes imaging. Those tests confirm or rule out TB. A general health screen does none of that and cannot.

What a screen can do is contribute to triage: helping identify people whose overall picture warrants proper TB evaluation, so they get referred for the real tests rather than slipping through. Triage widens the front door and points people toward the right diagnostic pathway. It never replaces that pathway. SamaClip is a triage and referral signal for conditions like TB — never a TB diagnostic. We say this plainly and we hold to it.

Why triage still matters enormously

If triage is "only" sorting and referral, why does it matter? Because the bottleneck in TB case-finding is often the sorting. People with early or non-specific symptoms do not present for TB testing, because nothing has told them to. They turn up for something vague — fatigue, feeling unwell — and leave without anyone connecting the dots toward a TB evaluation.

A community screening contact is an opportunity to catch some of those people and route them correctly. When someone is being screened anyway, in their own neighbourhood, by a trusted local worker, the moment can be used to ask the right questions and make the right referral. The screen does not diagnose the TB. It increases the chance that the person ends up in front of the test that will.

How it fits our model

This is the same logic that runs through everything we do. The screen is the wide, painless first contact that finds people and sorts them. The diagnostic pathway — accredited testing, the formal TB programme, clinical confirmation — is where the actual diagnosis happens. Triage feeds diagnosis. It does not pretend to be it.

For tuberculosis specifically, that means our role is to help the right people reach proper TB testing sooner, through referral, as part of broader community screening contact. It is a supporting role, and an honest one. Overclaiming here would not just be inaccurate. With a disease this serious, it would be dangerous. So we are clear: screening triages and refers. Diagnosis belongs to the tests built for it.