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    NHP 2

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    A J Fathima
    The document discusses the Revised National Tuberculosis Control Programme (RNTCP) in India. It outlines the objectives and strategies of the RNTCP, including DOTS and the Stop TB strategy. It describes the organization, laboratory network, diagnostics, initiatives, and treatment under the RNTCP. It also discusses management of drug-resistant TB, TB-HIV coordination, and the national strategic plan for TB elimination.

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    NHP 2

    Uploaded by

    A J Fathima
    533 views42 pages
    The document discusses the Revised National Tuberculosis Control Programme (RNTCP) in India. It outlines the objectives and strategies of the RNTCP, including DOTS and the Stop TB strategy. It describes the organization, laboratory network, diagnostics, initiatives, and treatment under the RNTCP. It also discusses management of drug-resistant TB, TB-HIV coordination, and the national strategic plan for TB elimination.

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    The document discusses the Revised National Tuberculosis Control Programme (RNTCP) in India. It outlines the objectives and strategies of the RNTCP, including DOTS and the Stop TB strategy. It describes the organization, laboratory network, diagnostics, initiatives, and treatment under the RNTCP. It also discusses management of drug-resistant TB, TB-HIV coordination, and the national strategic plan for TB elimination.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    533 views42 pages

    NHP 2

    Uploaded by

    A J Fathima
    The document discusses the Revised National Tuberculosis Control Programme (RNTCP) in India. It outlines the objectives and strategies of the RNTCP, including DOTS and the Stop TB strategy. It describes the organization, laboratory network, diagnostics, initiatives, and treatment under the RNTCP. It also discusses management of drug-resistant TB, TB-HIV coordination, and the national strategic plan for TB elimination.

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    of 42

    COURSE-B.

    SC NURSING IV YEAR

    SUBJECT:COMMUNITY HEALTH NSG II

    UNIT :6

    PART 2 :NATIONAL HEALTH AND FAMILY


    WELFARE PROGRAMMES AND ROLE OF NURSE

    REVISED NATIONAL TUBERCULOSIS CONTROL


    PROGRAMME (RNTCP)

    PREPARED BY
    J.POORNIMA MARY RODRIGUEZ
    ASSOCIATE PROFESSOR
    OBJECTIVES
    The students will be able to:
    ✔ Discuss the origin of the programme

    ✔ Identify the abbreviations

    ✔ Enlist the objective of the programme

    ✔ Elaborate on DOTS Strategy

    ✔ Appreciate on 2006 STOP TB Strategy


    CONT….

    ✔ Understand the Organization Pattern


    ✔ Narrate the Lab Network

    ✔ Describe on New TB Diagnostic techniques

    ✔ Recognize New initiatives in the programme

    ✔ Explain on Treatment Initiatives


    CONT….

    ✔ Explore on Management of Drug Resistant TB


    ✔ Appreciate on TB-HIV Coordination

    ✔ Discuss on National Strategic Plan(2017-2025)

    ✔ Identify on Financial Resources


    PROGRAM-OVERVIEW

    • Introduction
    • Origin of the programme

    • Abbreviation

    • Objectives

    • DOTS Strategy

    • 2006 Stop TB Strategy


    • Organization pattern
    • Lab Network

    • New TB Diagnostic Techniques

    • New initiatives

    • Treatment Initiatives
    • Management of Drug Resistant TB
    • TB-HIV Coordination
    • National Strategic Plan(2017-2025)
    • Financial Resources
    • Summary
    • References
    • Frequently asked questions
    INTRODUCTION
    The National Tuberculosis Programme has
    been in operation since 1962.
    Since, the treatment success rates were low,
    The Revised National TB Control Programme
    (RNTCP), based on Directly Observed
    Treatment Short-course (DOTS) strategy, was
    launched in 1997.
    ABBREVIATIONS

    • NTI-National Tuberculosis Institution


    • NIRT-National Institution of Research in TB
    • NITRD-National Institute of TB& Respiratory
    Disease
    • JALMA-Japanese Leprosy Mission for Asia
    • NTWG-National Technical Working Group
    • DST-Drug Sensitivity Testing
    • SDS-State Drug Store
    CONT….

    • IRL-Intermediate Reference Laboratory


    • DR-TB-Drug Resistant TB
    • DMC- Designated Microscopy Centers
    • STO- State Tuberculosis Officer
    • DEO- Data Entry Operator
    • STS- Senior Treatment Supervisor
    • STLS -Senior Tuberculosis Laboratory
    Supervisor
    • EQA-External Quality Assurance
    CONT…

    • DST-Drug-susceptibility testing
    • CBNAAT - cartridge based nucleic acid
    amplification test
    • NTF-National Task Force

    • ICT- Immunochromatographic test


    OBJECTIVES

    • Achievement of at least 85% cure rates of


    infectious cases of tuberculosis through DOTS.
    • Augmentation of case finding activity through
    quality sputum microscopy to detect at least 70%
    of estimated cases.
    FIVE MAIN COMPONENTS OF DOTS
    STRATEGY
    Political and administrative
    commitment.
    Diagnosis by quality assured sputum
    smear microscopy.
    Adequate supply of quality assured
    short course chemotherapy drugs

    Directly observed treatment

    Systematic monitoring and


    accountability
    COMPONENTS OF 2006 STOP TB
    STRATEGY
    Pursue quality DOTS -expansion and
    enhancement
    Addressing TB-HIV and MDR-TB

    Contribute to health system strengthening

    Engaging all care providers

    Empowering patients and communities

    Enabling and promoting research


    LABORATORY NETWORK
    RNTCP endorsed TB diagnostics

    • 1.Smear Microscopy for acid fast bacilli


    • 2.Culture

    • 3.Rapid diagnostic molecular test

    • 4.Radiography

    • 5.Tuberculin skin test


    NEW INITIATIVES
    1.NIKSHAY:TB surveillance using case based
    web based IT system
    This was launched in May 2012 and has following
    components:
    Master Management
    User details
    TB patient registration,diagnosis,DOT Provider,
    HIV status, follow up, outcomes
    Details of solid and liquid culture and
    DST,CBNAAT details
    DR-TB patient details
    Cont…..

    • Referral and transfer of patient


    • Private health facility registration and notification

    • SMS Alerts to patients

    • SMS Alerts to programme officers

    • Automated periodic reports


    2.TB NOTIFICATION

    • All healthcare providers to notify every TB case


    to District Health Officer/Chief Medical Officer of
    district and Municipal Health Officer every
    month.
    CONT….

    3.Ban on TB Serology:
    Currently available serological tests are having
    poor specificity and should not be used for
    diagnosis of TB.

    4.Direct benefit to transfer schemes:


    It is established by linking TB patients reported
    in NIKSHAY with AADHAR and
    PEMS(Predictive emission monitoring systems ).
    INITIATION OF TREATMENT
    FIXED DOSE COMBINATION FOR
    PAEDIATRIC TB(Daily dose regimen)
    MANAGEMENT OF DRUG
    RESISTANT TB
    STATE LEVEL STRUCTURE AND RESPONSIBILITIES
    • The state PMDT Committee should develop plan
    of action for implementation, expansion,
    maintenance,supervision, monitoring and quality
    enhancement of PMDT(The Programmatic
    management of drug-resistant TB) services.
    Drug Resistant tuberculosis centre

    1.District Drug Resistant tuberculosis centre to be


    established in medical colleges,district
    hospitals,Tbhospitals and NGO/private/corporate
    institutes. It is responsible for initiation and
    management of uncomplicated DR-TB Patients.
    Nodal DR-TB Centre:
    • Patients with additional resistance to second line
    drugs, drug intolerance in need of palliative care
    would be managed at Nodal DR-TB Centre
    The NDR-TB CENTRE

    • Should be a tertiary care institute


    • Separate ward for male and female patients

    • All services to be provided free of cost

    • All main specialities to be available

    • NDR-TBC Committee to be formed

    • Doctors, nursing and support staff should be


    available
    • Ancillary drugs to be available
    • Records and report to be maintained for PMDT

    • Quarterly report to be submitted electronically


    TB-HIV coordination
    • TB Case finding has been implemented in all
    HIV testing centers.
    • HIV Testing for all TB Patients

    • Persons found positive are eligible for free


    antiretroviral treatment.
    • Intensified case finding activities to be
    specifically monitored among HIV infected
    pregnant women and children
    • NACO and RNTCP have taken policy decision to
    adopt Isoniazid Prophylaxis therapy(IPT).
    • Rapid Diagnostic Tool has come to practice.
    NATIONAL STRATEGIC
    PLAN(2017-2025)for TB Elimination
    OBJECTIVES:
    • Find all drug sensitive TB and drug resistant TB
    cases
    • Initiate appropriate anti TB treatment
    • Prevent the emergence of TB in susceptible
    populations
    • Strengthen institutions and human resources
    KEY STRATEGIES

    • Private sector engagement


    • Active case finding
    • Drug resistant TB case management
    • Addressing social determinants including
    nutrition
    • Robust surveillance system
    • Community engagement and multi sectoral
    approach
    Expected outcome

    • 80% reduction in TB incidence


    • 90% reduction in TB mortality

    • 0% patient having catastrophic expenditure due


    to TB
    FOUR STRATEGIC PILLARS

    •DETECT
    •TREAT
    •PREVENT
    •BUILD APPROACH
    FINANCIAL RESOURCES

    • World Bank
    • Department for International Development
    • WHO
    • Global TB Drug Facility
    • Global Funds to Fight AIDS,TB & MALARIA
    • United States Agency for International
    Development
    • DANIDA
    SUMMARY

    • As Health personnel let us join hands to


    Eliminate TB by 2025.
    REFERENCES

    Park.k, “Text Book of Preventive and Social


    Medicine” ,24th edition, Banarsidas Bhanot
    publishers.
    FREQUENTLY ASKED QUESTIONS

    ESSAY
    • Revised National Tuberculosis control
    programme.
    SHORT NOTES(Expected):
    • Daily Treatment Regimen
    SHORT ANSWER
    • What is DOTS?
    THANK YOU

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