RNTCP programme.pdf

This ppt contains all the information about Revised NationalTuberculosis Control programme (RNTCP) It is useful for students of the medical field learning Preventive and social medicine, Swasthavritta (Ayurved) and everyone who is interested in in knowing about it.

1. Revised national Tuberculosis
Control programme(RNTCP)
Dr. ShubhangiS. Kshirsagar
Assistant professor
Department of Swasthavritta & Yoga
[email protected]

2. •NationalTuberculosisProgramme(NTP)launchedin
1962.
•However, thetreatment successrateswere
unacceptablylowandthedeathanddefaultrates
remainedhigh.SpreadofmultidrugresistantTBwas
threateningtofurtherworsenthesituation.
•Inviewofthis,in1992GovernmentofIndiaalong
withWHOandSIDAreviewedtheTBsituationinthe
countryandcameupwithfollowingconclusions:
✓NTP,thoughtechnicallysound,sufferedfrom
managerialweaknesses
✓Inadequatefunding,
✓Over-relianceonX-rayfordiagnosis
✓Frequent interrupted supplies of drugs
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3. ▪1993-RevisedNationalTBControlProgramme
(RNTCP)
▪Adopted theinternationallyrecommended
DirectlyObservedTreatmentShort-course(DOTs)
strategy
▪1
st
Jan2020–rename-Nationaltuberculosis
eliminationprogramme
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4. Objective of RNTCP
▪Toachieveatleast85%curerateofinfectious
casesoftuberculosisthroughDOTsinvolving
peripheralhealthfunctionaries.
▪Toachievecasefindingactivitiesthroughquality
sputummicroscopytodetectatleast70%of
estimatedcases.
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5. ▪Therevisedstrategywasintroducedinthecountry
inaphasedmannerasPilotPhaseI,PilotPhaseII
andPilot,PhaseIII.
▪Bytheendof1998,only2percentofthetotal
populationofIndiawascoveredbyRNTCP.
▪Large-scaleimplementationbeganinlate1998.
▪TheRNTCPhasexpandedrapidlyovertheyears
andsinceMarch2006,itcoversthewholecountry.
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6. Components of DOTs strategy
adopted by RNTCP
1.Diagnosisbyqualityassuredsputumsmear
microscopy.
2.Adequatesupplyofqualityassuredshortcourse
chemotherapydrugs
3.Directlyobservedtreatment(DOTs).
4.Systemicmonitoringandaccountability.
5.Politicalwillandadministrativecommitment
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7. STOP TB strategy –announced by
WHO & adopted by RNTCP (2006)
1.PursuingqualityDOTs–expansion&
enhancement.
2.AddressingTB/HIVandMDR-TB.
3.Contributingtohealthsystemstrengthening
4.Engagingallcareprovides.
5.Empoweringpatientandcommunities.
6.Enablingandpromotingresearch.
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8. Organization
The profile of RNTCP in a state is as follows :
▪State Tuberculosis Office -State Tuberculosis Officer
▪State Tuberculosis Training and Demonstration Centre –
Director
▪District Tuberculosis Centre -District Tuberculosis Officer
▪Tuberculosis unit -Medical Officer TB Control
Senior Treatment Supervisor
Senior TB Laboratory Supervisor
▪Microscopy Centres, Treatment Centres
▪DOTS Providers
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10. Laboratory network
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11. RNTCP endorsed TB diagnostics
1. Smear microscopy for acid fast bacilli.
a. Sputum smear stained with Zeihl-Neelsenstaining or
b. Fluoresencestains and examined under direct or
indirect microscopy with or without LED
2. Culture
a. Solid (Lowenstein Jansen) media or
b. Liquid media (Middle Brook) using manual semiautomatic
or automatic machines, e.g. Bactec, MGIT etc.
3. Rapid diagnostic molecular test
a. Conventional PCR based Line Probe Assay for MTB
complex or
b. Real-time PCR based Nucleic Acid Amplification Test
NAAT for MTB complex, e.g. GeneXpert
4. Radiography where available
5. Tuberculin skin test
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13. New initiatives
1.Nikshay: TB surveillance using case based-web
based IT system (2012)
1.TB notification -According to GOI notification
(7
th
May 2012)-it is mandatory for all healthcare
providers to notify every TB case to local
authoritiesi.e. DHO/CMO, in every month in a
given format.
3. Ban on TB serology -Serological test are based on
antibody response, and highly variable in TB and
may reflect remote infection rather than active
disease.
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14. Newer initiatives
1.Daily regimen for paediatricTB
2.Daily regimen for all forms of TB in the
country
3.Pilots for universal access to TB cases
4.Bedaquillineconditional access
programme
5.Campaign mode-Active case finding
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18. National strategic plan (NPS)
2017-2025 for TB elimination
Vision–TB free India with zero deaths, disease
and poverty due to TB
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19. Objectives of NPS–
1.FindalldrugsensitiveTBanddrugresistantTB
caseswithanemphasisonreachingTBpatient
seekingcarefromprivateprovidersand
undiagnosedTBinhighriskgroup.
2.Initiateandsustainallpatientonappropriate
treatmentwherevertheyseekcare,withpatient
friendlysystemsandsocialsupports.
3.PreventemergenceofTBsusceptiblepopulations.
4.Buildandstrengthenenablingpolicies,empowered
institutions,additionalhumanresourceswith
enhancedcapacitiesandproveadequatefinancial
resources.
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20. Strategies
1.Private sector engagement
2.Active case finding
3.Drug resistant TB case management
4.Addressing social determinants including
nutrition
5.Robust surveillance system
6.Community engagement and multisectoral
approach
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21. Expected outcome
▪Aim of NSP –To achieve elimination of TB by
2025 .
▪During plan period, targets for TB are
1.80% reduction in TB incidence
2.90% reduction in TB mortality
3.0% patient having catastrophic expenditure
due to TB.
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22. Thank You
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