Drone-based sputum transport for TB diagnosis in remote communities

SUMMARY BACKGROUND TB remains a major public health concern in India where diagnostic delays persist. This study assessed the impact of drone-based sputum transport on turnaround time (TAT) and access to TB care in Telangana’s Yadadri-Bhuvanagiri district. METHODS A quasi-experimental mixed-methods study was conducted under the Indian Council of Medical Research’s i-DRONE initiative. Intervention included pre-drone phase (ground transport of samples) and drone phase (drone-based transport of samples). Outcomes: TAT, patient and diagnostic delay, and out-of-pocket expenditure (OOPE). Quantitative data were analysed using Jamovi and MS Excel; qualitative insights were gathered from open-ended remarks and observations made during the field. RESULTS A total of 840 individuals (206 in the pre-drone phase and 634 in the drone phase) were enrolled. The median TAT reduced from 15 days (interquartile range [IQR]: 10–20) in the pre-drone phase to 5 days (IQR: 2–9) in the drone phase, and the mean (standard deviation) TAT dropped from 16.6 days (18.1) to 6.9 days (8.3) ( P < 0.001). The mean OOPE declined from INR 9,451 (∼USD 113.4) to INR 90.9 (∼USD 1.0). Patients reported travel difficulties, loss of daily wages, and stigma as reasons for delaying care. CONCLUSION Significant reduction in the TAT and improved access to TB diagnosis in rural and remote Indian settings support the feasibility of scaling drone-based logistics within national TB elimination efforts.