National Tuberculosis Elimination Programme updateds new.pptx

National TB Elimination Pgme

1. NTEP Updates

2. Section - A

3. TB at a glance… Challenges Ahead ……

4. India is the highest TB burden country Data source: Global TB Report2021, WHO, Geneva Philipines (5.9%) Paediatric TB- 31% of Global Burden Estimated Global annual incidence = 99.6 Lakhs Estimated India annual incidence = 25.9 Lakhs TB in Pregnant Women- 20.6% of Global Burden

5. 2015 2020 2023 2025 End TB Targets- India- 2025 Number per 100,000 population per year 204 Mortality reduction by 90% (3 per lakh) Incidence reduction by 80% (44 per lakh) ZERO Catastrophic Cost Of baseline 2015 2019- 193/L 2020- 188/L 2019- 32/L 2020- 36/L Current Rate of Annual decline is 3% Required rate of Annual decline is 15%

6. Gap between estimates and Notification- India (numbers in Lakhs) GAP Incident cases= New + Relapse Gap has increased in huge proportion due to COVID in 2020

7. Onion Peel Model showing Reasons for Missed Cases Has access to health facilities but do not go Presenting to Health facilities but are undiagnosed Diagnosed by Public or Private but not Notified Presumptive TB Management Strengthening Supervision and Monitoring Surveillance system Suboptimal access to Health care/ TB care Health System Strengthening Advocacy, Communication and Social Mobilization Interventions

8. National TB Prevalence Survey - Summary For every 2.8 TB cases prevalent in the community, 1 case gets notified and 1.8 cases get missed Prevalence : Notification ratio 2.84 Chest X-ray – Additional yield 42.6% Patients with past H/o TB 23.4% among those diagnosed Patients with past H/O TB contribute significantly to the total cases Screening Tests-- Addition of diagnostic tests like Chest X ray adds to the yield Interpretation : Find and Notify TB cases from ALL possible avenues Symptomatic persons has to undergo NAAT or microscopy AND Chest Xray for diagnosis of TB. Addition of Chest X ray adds to the yield of TB cases Long term Follow up of successfully treated TB patients is essential to get more cases

9. National TB Prevalence Survey - Summary Health care seeking behaviour Did not seek care 63.6% Among those found to be symptomatic during the survey 69% in WB Costs incurred – Govt. facility Rs. 7500.00 Costs incurred – Private facility Rs. 20000.00 Public and private facility preferences 49% - 49% Among the 5156 sought health care 63% - 36% in WB Max: 39000 Min:1500 Median costs among those currently on ATT Interpretation : Base line incidence of TB cases in N-Pg -> 2015-62.40/L/Y 2021-47/L/Y Proportion of Notification from Private is less (missed cases) Seeking Health care if chest symptomatic is not a felt need-- lack of awareness Out of Pocket expenses exist for TB care both in the public and private sector

10. Digital Interventions Nikshay module for DR-TB DBT PFMS 99 DOTS for adherence support Nikshay Aushadhi GeneXpert machine to Nikshay Mobile version (app) for Nikshay