35.Nationalhealthprogrammesdiseasedetectionandreporting.pdf

Health programme regarding communicable diseases widespread in india

1. Chapter 35
National Health
Programmes,
Disease Detection
and Reporting
Dr Sonal Saxena
Dr Arpita Saxena

2. INTRODUCTION
Health is a basic human right. With this vision, national
health programmes are designed to achieve the objective
of ensuring accessible health for affected individuals.
Objectives
❖Disease detection and prevention are vital and should be
accessible to all individuals in the programme.
❖The availability of simple, easy-to-perform, and
affordable tests is a basic necessity for proper
management.
❖Rapid control measures are required to contain
infections and prevent large-scale outbreaks.

3. Types of
National
Programs
❖Infectious diseases -Communicable Disease Programmes.
❖Non-infectious diseases-Non-Communicable Disease
Programmes.
Communicable Disease Programmes under National Health
Mission
❖National health programmes are central government-
sponsored programmes which are constantly monitored, and
under which strategies are planned according to the disease
status in the country.

4. National TB Elimination Programme
(NTEP)
❖Earlier known as the Revised National TB Control Programme (RNTCP).
❖National strategic plan for tuberculosis elimination (2017–2025).
Basic principle
❖‘Universal access to quality diagnosis and treatment for all TB patients in the community’ with a
target of ‘reaching the unreached’.
Testing and screening for pulmonary TB
❖Any person with symptoms and signs suggestive of TB including cough >2 weeks, fever >2 weeks,
significant weight loss, hemoptysis, any abnormality on a chest radiograph, children with persistent
fever and/or cough >2 weeks, loss of weight/absence of weight gain and/or contact with pulmonary
TB cases must be evaluated for TB.
❖Microbiological confirmation by sputum microscopy for AFBs on at least two samples, including one
early morning sample
❖Treatment strategies for active new cases, drug-resistant cases included.

5. Objectives of RNTCP
❖To reduce the incidence and mortality due to TB.
❖To prevent further emergence of drug resistance and
effectively manage drug-resistant TB cases.
❖To improve outcomes among HIV-infected TB patients.
❖To involve private sector on a scale commensurate with
their dominant presence in healthcare services.
❖To further decentralise and align basic RNTCP management
units with National Rural Health Mission block level units
within the general health system for effective supervision
and monitoring

6. Goals of the NTEP
•The foremost goal is to achieve a
rapid decline in the burden of TB
morbidity and mortality while
working towards elimination of TB
in India by 2025.
•The requirements for moving
towards TB elimination have been
integrated into the four strategic
pillars of ‘Detect – Treat – Prevent
– Build’ (DTPB)’

7. Objectives of RNTCP
❖Scale up free, high-sensitivity diagnostic tests and algorithms
❖Scale up effective private provider engagement approaches
❖Institute universal testing for drug-resistant TB
❖Establish systematic screening of high-risk populations
❖Prevent the loss of TB cases in the cascade of care with support systems
❖Provide free TB drugs for all TB cases
❖Develop a universal daily regimen for TB cases and rapid scale up of short-course regimens for
drug-resistant TB and DST-guided treatment approaches

8. Objectives of RNTCP
❖Establish patient-friendly adherence monitoring and social support to sustain TB treatment
❖Eliminate catastrophic costs by linking eligible TB patients with social welfare schemes
including nutritional support
❖Scale up air-borne infection control measures at healthcare facilities
❖Ensure testing and treatment for latent TB infection in contacts of bacteriologically-confirmed
cases and in individuals at high risk of getting TB disease
❖Address social determinants of TB through intersectoral approach
❖Translate high level political commitment into action through supportive policy and
institutional structure

9. National Leprosy
Eradication
Programme
(NLEP)
History
❖National Leprosy Control Programme (NLCP) was launched
by the Government of India in 1954–55 with vision of a
‘leprosy-free India’.
❖Programme was initially taken up in endemic districts and
was extended to all districts in the country from 1993–94.
❖Strategy of the NLEP was based on controlling the disease
through a reduction in the quantum of infection in the
population and reduction in infective source, thus breaking
the chain of disease transmission

10. Mission
To provide quality leprosy services free of cost to all sections of
the population, with easy accessibility through the integrated
healthcare system including care for disability after cure of the
disease.

11. Objectives
To reduce the prevalence of leprosy to less than 1/10,000
population at the sub-national and district levels.
To reduce Grade II disability percentage to <1 among new
cases at the national level.
To reduce Grade II disability cases to <1 case per million
population at the national level.
Zero disabilities among new childhood cases.
Zero stigma and discrimination against persons affected
by leprosy.

12. Strategy
Early detection through active surveillance by trained health workers
Regular treatment of cases by instituting multi-drug therapy (MDT) centres in villages in
moderate-to- low endemic areas/districts
Intensified health education and public awareness campaigns to remove social stigma attached
to the disease
Appropriate medical rehabilitation and leprosy ulcer care services

13. National Vector-Borne Disease Control
Programme (NVDCP)
History
This programme was launched in 2003–04 to control vector-borne diseases.
Includes
◦National Malaria Control Programme
◦National Filaria Control Programme
◦Kala-azar Control Programmes
◦Japanese B encephalitis Control Programme
◦Dengue/DHF Control Programme

14. GOALS
Prevention and control of six vector-borne diseases
(VBDs)—malaria, dengue, lymphatic filariasis, kala-
azar, Japanese encephalitis, and chikungunya in
India.
Out of these six diseases, three diseases, namely
malaria, lymphatic filariasis, and kala-azar are
targeted for elimination.

15. Activities
❖Surveillance of vector-borne diseases.
❖Awareness campaigns.
❖Specific preventive measures like mosquito control, medication, etc.

16. National AIDS Control
Programme (NACP)
Objective
❖To reduce new infections by 50%.
❖Provide comprehensive care and support to all persons living with
HIV/AIDS and treatment services for all those who require it.
❖National AIDS Control Organisation (NACO) is the nodal
organisation for national AIDS response in the Ministry of Health
and Family Welfare.
❖Started in 1992, now in Phase IV.

17. National AIDS Control
Programme (NACP)
The nodal agency is the National AIDS Control Organisation
(NACO) in the Ministry of Health and Family Welfare.
History
❖The NACP was initiated in 1992 by the Govt. of India to
detect, treat, and control HIV infection (NACP I).
❖It has been a successful programme which now provides
testing, treatment, and prevention services throughout the
country.
❖It is now in the fourth phase (NACP IV).

18. Mission
❖To reduce new infections by 50% and provide
comprehensive care and support to all persons living with
HIV/AIDS and treatment services for all those who require it.
❖To slow down the spread of HIV infections so as to reduce
the morbidity, mortality, and impact of AIDS in the country.

19. Objectives
❖To reduce the spread of HIV infection in India
❖To increase India’s capacity to respond to HIV/ AIDS on a long-term basis
❖To build an integrated response by reaching out to diverse populations

20. Activities
Counselling and testing services
Community-based screening, integrated counselling and testing services, monitoring of HIV load and CD4
counts in patients on antiretroviral therapy.
Provision of antiretroviral treatment.
Preventive services—prevention and care, support and treatment for people living with HIV (PLHIV),
awareness generation, condom promotion, prevention of parent-to-child transmission, increasing ICTC
services, promotion of voluntary blood donation, and access to safe blood
Targeted interventions for high-risk groups like injectable drug users, men having sex with men, female sex
workers, etc.
Information, education, communication (IEC)
Blood and organ safety
HIV-TB collaborative activities

21. Integrated Disease Surveillance
Project(IDSP)
History
❖The Integrated Disease Surveillance Project (IDSP) was launched by Hon’ble Union Minister of
Health and Family Welfare in November 2004 for a period upto March 2010.
❖The project was restructured and extended up to March 2012.
❖It continues in the 12th Plan with domestic budget as
❖Integrated Disease Surveillance Programme under the National Health Mission for all States

22. Mission
To strengthen the disease surveillance in the country by
establishing a decentralised state-based surveillance system for
epidemic-prone diseases to detect the early warning signals so
that timely and effective public health actions can be initiated in
response to health challenges in the country at the districts,
state, and national levels.

23. Objectives
To strengthen/maintain decentralised
laboratory- based, IT-enabled disease
surveillance systems for epidemic-prone
diseases to monitor disease trends and to
detect and respond to outbreaks in the early
rising phase through trained rapid response
teams (RRTs).

24. Components
❖Integration and decentralisation of surveillance activities
through the establishment of surveillance units at the
central, state, and district levels—under the programme, a
Central Surveillance Unit (CSU) at Delhi, State Surveillance
Units (SSU) at all State/UT head quarters, and District
Surveillance Units (DSU) in all districts in the country have
been established
❖Human resource development
❖Use of information communication technology for the
collection, collation, compilation, analysis, and dissemination
of data
❖Strengthening of public health laboratories
❖Intersectoral co-ordination for zoonotic diseases through
the one-health approach

25. SURVEILLANCE
INCLUDES
❖Epidemiological surveillance
❖Laboratory surveillance
❖Ecological surveillance
❖Anthropological surveillance
❖Investigation and early control measures
❖Monitoring and evaluation
❖Disease detection and reporting

26. National Viral Hepatitis Control Programme
(NVHCP)
Objectives
❖Establish a laboratory network for the surveillance of viral hepatitis
❖Determine prevalence of different types of viral hepatitis
❖Provide laboratory support for outbreak investigation of hepatitis through the established
network of laboratories
❖Generate awareness among healthcare providers and in the community about waterborne and
blood- borne hepatitis by creating information and education materials

27. National Viral Hepatitis Control Programme
(NVHCP)
History
❖The National Viral Hepatitis Control Programme was launched on 28 July 2018 on the occasion
of World Hepatitis Day.
Mission
❖Combat hepatitis and achieve country-wide elimination of hepatitis C by 2030
❖Achieve significant reduction in the infected population, morbidity, and mortality associated
with hepatitis B and C viz. cirrhosis and hepatocellular carcinoma (liver cancer)
❖Reduce the risk, morbidity, and mortality due to hepatitis A and E

28. Components
❖Preventive component: Increasing awareness, immunisation against
hepatitis B, safety of blood and blood products, injection safety, safe
socio- cultural practices, safe drinking water, hygiene, and sanitary
practices
❖Diagnosis and treatment: Screening of pregnant women for HBsAg,
free screening, diagnosis and treatment for both hepatitis B and C,
provision of linkages, including with private sector and not- for-profit
institutions for diagnosis and treatment, engagement with
community/peer support to enhance and ensure adherence to
treatment and demand generation.
❖Monitoring and evaluation, surveillance, and research
❖Training and capacity building

29. National
Programme on
Containment of
Antimicrobial
Resistance
(AMR)
History
❖The rapid spread of multi-resistant bacteria and the lack of
new antibiotics to treat infections caused by these organisms
pose a rapidly increasing threat to public and animal health.
❖To tackle this issue, the Government of India has launched a
‘National Programme on Containment of Antimicrobial
Resistance’ under the 12th five-year plan (2012–2017).
❖It is coordinated by Centre for Bacterial Diseases and Drug
Resistance, National Center of Disease Control.

30. National
Programme on
Containment of
Antimicrobial
Resistance (AMR)
Objectives
❖To establish a laboratory-based AMR surveillance system
of network labs in the country and to generate quality
data on antimicrobial resistance for pathogens of public
health importance
❖To strengthen infection control guidelines and practices
and promote the rational use of antibiotics
❖To generate awareness among healthcare providers and
in the community about the rational use of antibiotics

31. Activities
❖Surveillance for containment of AMR in various geographical
regions
❖Rational use of antibiotics
❖Development & implementation of national infection control
guidelines
❖Training and capacity building of professionals in relevant
sectors
❖IEC for dissemination of information about the rational use of
antibiotics
❖Development of national repository of bacterial strains/
cultures

32. COVID-19 Pandemic management
❖By setting up several task forces & steering committees for COVID-19 detection
❖By setting up isolation and treatment centers in several public and private sector hospitals
❖By initiating the setting up of screening and testing laboratories across the country
❖By instituting upgraded laboratories and capacity for molecular tests
❖Integrated Disease Surveillance Programme data was coordinated through online portals,
which allowed for real-time data analysis to initiate management measures and documentation
along with the state health department

33. BIOTERRORISM
Bioterrorism (CDC) is the deliberate release, by
attackers, of an agent that causes one or more
of a variety of different diseases.