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REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME Presentation by DR.

REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME Presentation by DR. VIOLET (de Sa) PINTO Lecturer , department of PSM . Objectives:. At the end of the session the student shall have knowledge of :

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REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME Presentation by DR.

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  1. REVISED NATIONAL TUBERCULOSISCONTROL PROGRAMME Presentation by DR. VIOLET (de Sa) PINTO Lecturer , department of PSM

  2. Objectives: At the end of the session the student shall have knowledge of : • Differences between NTP and RNTCP • Basics of NTP • RNTCP, its aims and components, the salient features for initiating treatment, steps of diagnosis treatment categories and management of patients who interrupt treatment. • Drug resistance problem in RNTCP • Basics of Paediatric TB therapy

  3. NATIONAL TB CONTROL PROGRAMME DISTRICT TUBERCULOSIS PROGRAMME (backbone of NTP) • 600 TB clinics & over,390 upgraded to District TB Centers. (DTC – nucleus of DTP) • Evolved by National TB Institute, Bangalore • Plan, organize & implement DTP in district with health services. • Institutions available- Government ,general hospitals, TB clinics other than DTC, PHC’s, dispensaries, health unit, those managed by GH schemes (CGHS, ESIS), local bodies, religious missions, voluntary organizations, private charitable societies PHI’s (Implementable PHI’s) • 17 TB training and demonstration centers established in major states • 2 premier institutes, Bangalore & Chennai • Case finding & treatment, free, domiciliary basis

  4. REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME

  5. Aims to provide standardized treatment and diagnostic facilities to all TB patients, irrespective of health facility from which they seek treatment. Access to marginalized groups, urban slum dwellers & tribal groups and areas. National infrastructure while incorporating internationally recommended DOTS.

  6. SALIENT FEATURES FOR INITIATING TREATMENT • No active case finding • Examination at designated microscopy centers • DOTS ( Directly Observed Treatment Short-Course) Combined benefits of community based care & support Supervised treatment • Political commitment • Good quality sputum microscopy • Directly observed treatment • Uninterrupted supply of good quality drugs. • Accountability Patient wise boxes • EQA, DOTS- Plus, Paediatric drug boxes. Components

  7. DIAGNOSIS OF TUBERCULOSIS Cough for 3 weeks or more 3 sputum smears 3 or 2 positives 1 positive 3 negative Xray AB treatment 2 weeks positive negative symptoms persist xray negativepositive Smear +ve TB Non-TBSmear –ve TB Anti TB TreatmentAnti TB Treatment

  8. FROM NTP RNTCP

  9. DRUG RESISTANCE UNDER RNTCP • DR prevalence – Indicator of effectiveness of TB Control Activities Determine prevalence of antimicrobial resistance among new sputum +ve & previously treated smear –ve • Survey not evenly distributed • New protocols for state wise DRS under RNTCP Since 2005 AP, Gujarat, Maharashtra, Orissa, Kerala, Delhi, WestBengal, UP. Covering almost 54% population Another survey to be carried out after 5 years, same states,same methodology • ICMR-DRS – TN & Sikkim • 2010- Network of 24 assured and accredited state –level culture % drug sensitivity testing laboratories.

  10. PAEDIATRIC TB • 2003 consultation of national & international experts on TB & pediatrics • Modification of guidelines for diagnosis and treatment • Patient –wise boxes • Treatment based on child’s body weight 6- 10 kg 11-17kg • < 6 kg loose anti TB drugs.

  11. Part II • Organization under RNTCP • TB and HIV • DOTS Plus

  12. Thank you

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