New Delhi: A simple calculator developed by Indian researchers can predict which tuberculosis (TB) patients are at the highest risk of death at the time of diagnosis itself, according to a study published in BMJ Open. Researchers say the tool could help identify high-risk patients early and support efforts to reduce TB deaths.The tool, developed by researchers from the ICMR-National Institute of Epidemiology (NIE), Chennai, and the Tamil Nadu TB programme, uses basic clinical measurements routinely available when a patient is diagnosed with TB. The authors say it could be useful in resource-constrained settings seeking scalable, data-driven interventions to reduce TB mortality.The study analysed data from 55,971 adult TB patients notified from public health facilities across Tamil Nadu between July 2022 and June 2023. It found that 7.4 per cent of patients died within a year of diagnosis, with nearly 68 per cent of those deaths occurring within the first two months.The calculator relies on simple indicators such as body mass index (BMI), oxygen saturation, respiratory rate, pedal oedema and the patient’s ability to stand without support. When combined with age, sex, site of disease, previous treatment history and microbiological confirmation, the model was able to accurately predict the risk of death.Researchers found that these simple triage indicators performed almost as well as more complex models based on multiple variables available later through the government’s Ni-kshay TB database.The authors have recommended that severe-illness indicators be routinely captured at the time of TB diagnosis. They also developed a TB death prediction calculator based on these variables for prospective use at diagnosis.The study was led by researchers including Suseendar Shanmugasundaram, Dr Hemant Deepak Shewade and colleagues from ICMR-NIE, Chennai, along with officials from the Tamil Nadu TB programme. Senior author Dr Manoj V Murhekar, Director of ICMR-NIE, was among the researchers involved in the work.India accounts for the world’s largest TB burden and reducing TB mortality remains a major public health challenge despite improvements in diagnosis and treatment. The researchers said the calculator could be used by Indian states and other high-burden countries seeking practical ways to identify vulnerable patients earlier.