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Revised National TB Control Programme

Revised National TB Control Programme. central tb division. Content. Burden of disease & key challenges Progress so far Newer interventions CRM ToR /Checklist. Burden of disease. Required rate in decline. WHO Global TB Report 2018. Key challenges.

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Revised National TB Control Programme

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  1. Revised National TB Control Programme central tb division

  2. Content • Burden of disease & key challenges • Progress so far • Newer interventions • CRM ToR/Checklist

  3. Burden of disease Required rate in decline WHO Global TB Report 2018

  4. Key challenges • Access to sensitive diagnostic tools at point of care – CXR & Rapid molecular tests • Under reporting and uncertain care of TB patients in private sector • Drug resistant TB – long duration & poor treatment outcomes • Airborne spread of infection – limited preventive measures • Determinants of disease beyond health

  5. Progress during last 5 years & Current status Numbers in lakh

  6. Progress during last 5 years & Current status Including patients in private sector

  7. Newer InterventionsDiagnosis and Treatment • 1180 CBNAAT Laboratories • 80 mobile TB diagnostic vans • Active TB Case Finding Strategy • Universal Drug Susceptibility Testing – • Second line DST for all Drug Resistant TB patients • First Line DST for Rifampicin Sensitive TB patients • Shorter regimen for Drug Resistant TB • Bedaquilinecontaining regimen for Drug Resistant TB • Delamanid Containing Regimen • Injection free regimen • Category II regimen stopped • INH resistant regimen change • MDR regimen changed • District level DR-TB Centres

  8. Newer InterventionsPatient Support & Service Expansion • Private Sector Engagement • Re-inforce Schedule H1 implementation • Public Private Support Agency (PPSA) • Incentives to Private Providers • Gazette Notification on mandatory notification • NIKSHAY Poshan Yojana – Rs. 500/- per month to every TB patients • NIKSHAY Enhancement • NIKSHAY Aushadhi – Drug Distribution Management System • Tablet/computer provided to Staff • TB Forum – for community led response

  9. TB Services at Community / Sub-centre

  10. CRM ToR/Checklist (Community / Sub-centre) Is community aware about TB symptoms? Did staff visited house for survey and asked about TB symptoms? Is community aware about availability of TB test and treatment? Are test and treatment available free? (incl. pvt.) Is community aware of benefits under NPY? In tribal area, is community / patient aware of assistance to patient? Are referral services available from Sub-centre? Is sample transport service available? Is Sub-centre staff undertaking public health action? Are drugs available at sub-centre for TB patients in area? Are records (treatment cards) of TB patients in their area available and used to track patients adherence?

  11. TB Services at PHC/CHC

  12. CRM ToR/Checklist (PHC & CHC) If microscopy centre, functional microscope, lab consumable? Where is X-ray conducted? Free / not? If microscopy centre, what is coverage of DST? If not microscopy centre, is sample transport service available? Are notification register (physical and NIKSHAY) available? What is coverage of HIV testing? Proportion of private health facilities engaged? Are anti-TB drug available at PHC/CHC for TB patients in area? At what frequency TB patients’ treatment is monitored? Is PHC/CHC staff undertaking public health action? What is contact investigation and chemoprophylaxis coverage? If TB unit, what is NPY coverage? If TB unit, what is NIKSHAY entry status If TB unit, treatment completion rates If TB unit, supervision visit to health facilities

  13. TB Services at District Hospital

  14. CRM ToR/Checklist (District Hospital) If microscopy centre, functional microscope, lab consumable? Where is X-ray conducted? Free / not? Where is pediatric TB and extra-pulmonary TB diagnosed? If microscopy centre, what is coverage of DST? If not microscopy centre, is sample transport service available? Are notification register (physical and NIKSHAY) available? What is coverage of HIV testing? Proportion of private health facilities engaged? What is CBNAAT utilization rate?

  15. CRM ToR/Checklist (District Hospital) At what frequency TB patients’ treatment is monitored? Is DTC staff undertaking public health action? What is contact investigation and chemoprophylaxis coverage? What is NPY coverage? What is NIKSHAY entry status What is treatment completion rates What supervision visit to health facilities At drug store, what is stock available? (shortage/ expiry?

  16. State / District TB Score • TB notification rate (cases / lakh / per year) • Treatment success rate of notified TB patients • % of TB patients with known HIV status • % of TB patients with drug susceptibility testing • % of DR-TB patient initiated on treatment • % of TB patients provided benefit of Nikshay poshanyojana • % of eligible patient provided IPT (Children / PLHIV) • % of HR in place at State and District level • % of expenditure • CBNAAT utilization rate • District DR-TB centres • Sample transport facility • Active TB Case Finding • Private sector engagement effort • Community engagement effort

  17. Thank You

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