7.Rntcp

8,075 views
7,760 views

Published on

Published in: Health & Medicine
0 Comments
9 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
8,075
On SlideShare
0
From Embeds
0
Number of Embeds
7
Actions
Shares
0
Downloads
440
Comments
0
Likes
9
Embeds 0
No embeds

No notes for slide

7.Rntcp

  1. 1. BY R.SIVAPIYA 72
  2. 2. <ul><li>REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME </li></ul><ul><li>ORIGIN </li></ul><ul><li>NATIONAL TB PROGRAM (NTP) 1962 </li></ul><ul><li>RNTCP IS THE REVIEWED FORM OF NTP </li></ul><ul><li>NEED FOR REVISED STRATEGY </li></ul><ul><li>-OVER EMPHASIS ON X-RAYS FOR DIAGNOSIS </li></ul><ul><li>-INADEQUATE FUNDING,POOR QUALITY MICROSCOPY </li></ul><ul><li>-NON-STANDARD TREATMENT REGIMENS </li></ul><ul><li>-LOW RATES OF TREATMENT COMPLETION </li></ul><ul><li>-LACK OF SYSTEMATIC INFORMATION ON TREATMENT OUTCOME </li></ul><ul><li>-ONLY 30% OF ESTIMATED TB PATIENTS WERE DIAGONOSED </li></ul><ul><li>-ONLY 30% OF THE DIAGONOSED CASES WERE TREATED SUCCESSFULLY </li></ul><ul><li>RNTCP STARTED IN YEAR 1992 (GOVT. OF INDIA,WHO,WORLD BANK) </li></ul>
  3. 3. <ul><li>GOAL </li></ul><ul><li>TO REDUCE MORTALITY AND MORBIDITY FROM TB </li></ul><ul><li>TO INTERRUPT CHAIN OF TRANSMISSSION </li></ul><ul><li>OBJECTIVES </li></ul><ul><li>ACHIEVEMENT OF AT LEAST 85%CURE RATE OF INFECTIOUS CASES </li></ul><ul><li>DETECTION OF ATLEAST 70%OF ESTIMATED CASES </li></ul><ul><li>INFORMATION, EDUCATION, COMMUNICATION AND IMPROVED OPERATIONAL RESEARCH ACTIVITIES. </li></ul><ul><li>COMPONENTS </li></ul><ul><li>POLITICAL COMMITMENT </li></ul><ul><li>GOOD QUALITY SPUTUM MICROSCOPY </li></ul><ul><li>UNINTERRUPTED SUPPLY OF GOOD QUALITY DRUGS </li></ul><ul><li>DIRECTLY OBSERVED TREATMENT </li></ul><ul><li>ACCOUNTABILITY </li></ul>
  4. 4. ORGANIZATION-PROFILE AT STATE LEVEL STATE TUBERCULOSIS OFFICE - STATE TUBERCULOSIS OFFICER STATE TUBERCULOSIS TRAINING & DEMONSTRATION CENTRE - DIRECTOR DISTRICT TUBERCULOSIS CENTRE (DTC) - DISTRICT TUBERCULOSIS OFFICER TUBERCULOSIS UNIT - MEDICAL OFFICER - SENIOR TREATMENT SUPERVISOR(STS) - SENIOR TB LAB SUPERVISOR(STLS) MICROSCOPY CENTRES AND TREATMENT CENTRES DOTS PROVIDERS
  5. 5. LABORATORY NETWORK CENTRAL TB DIVISION NATIONAL REFERENCE LAB STATE TB CELL INTERMEDIATE REFERENCE LAB DISTRICT TB CENTRE TU TU TU DMC II DMC I DMC III NATIONAL LEVEL STATE LEVEL DISTRICT LEVEL (SPUTUM MICROSCOPY EQA) (SUPERVISION) (FEEDBACK)
  6. 6. <ul><li>ROLE OF EACH LEVEL OF LABORATORY </li></ul><ul><li>NATIONAL REFERENCE LABORATORTY(NRL) </li></ul><ul><li>3 CENTRES- NEW DELHI, CHENNAI AND BANGALORE </li></ul><ul><li>EACH CENTRE CONTROLS OVER 8-11 STATES </li></ul><ul><li>SUPERVISES SPUTUM MICROSCOPY EQA ACTIVITIES. </li></ul><ul><li>INTERMEDIATE REFERENCE LABORATORY(IRL) </li></ul><ul><li>STATE TB TRAINING AND DEMONSTRATION CENTRES </li></ul><ul><li>OR </li></ul><ul><li>PUBLIC HEALTH LAB/MEDICAL COLLEGE LABORATORY </li></ul><ul><li>CONDUCTS SPUTUM MICROSCOPY EQA FOR THE STATE </li></ul><ul><li>PROVIDES TECHNICAL TRAINING TO THE DISTRICT AND SUB DISTRICT TECHNICIANS AND SENIOR TB LAB SUPERVISORS. </li></ul><ul><li>CONDUCTS ON SITE EVALUATION VISITS OF EACH DTC ATLEAST ONCE A YEAR </li></ul><ul><li>MANUFACTURES SLIDES FOR PANEL TESTING </li></ul>
  7. 7. <ul><li>DISTRICT TB CENTRES </li></ul><ul><li>CONDUCTS BLINDED RE-CHECKING OF SMEARS </li></ul><ul><li>MAINTAIN GOOD QUALITY REAGENTS AND EQUIPMENTS AT ALL TB UNITS </li></ul><ul><li>TUBERCULOSIS UNITS </li></ul><ul><li>AT SUB- DISTRICT LEVEL </li></ul><ul><li>1 TB UNIT PER 5 LAKH POPULATION( IN HILLY AREAS 2.5 LAKH) </li></ul><ul><li>CONDUCTS ON-SITE EVALUATIONS AND BLINDED RE-CHECKING OF SMEARS </li></ul><ul><li>DESIGNATED MICROSCOPY CENTRES </li></ul><ul><li>AT PERIPHERAL LEVEL </li></ul><ul><li>1 PER 1 LAKH POPULATION( IN HILLY AREAS 50000) </li></ul><ul><li>LOCATED AT EITHER IN CHC, PHC, TALUKA HOSP, TB DISPENSARIES </li></ul><ul><li>EACH CENTRE HAS A SKILLED TECHNICIAN </li></ul><ul><li>A SENIOR TB LAB SUPERVISOR(STLS) IS APPOINTED FOR EVERY 5 MICROSCOPY CENTRES </li></ul>
  8. 8. <ul><li>TREATMENT CENTRES </li></ul><ul><li>PROVIDES DRUGS FREE OF COST </li></ul><ul><li>THREE COMPONENTS </li></ul><ul><li>APPROPRIATE MEDICAL TREATMENT </li></ul><ul><li>SUPERVISION AND MOTIVATION </li></ul><ul><li>MONITORING OF THE DISEASE STATUS </li></ul><ul><li>DOTS PROVIDERS </li></ul><ul><li>MAY BE A PERIPHERAL HEALTH STAFF OR VOLUNTARY WORKERS(TEACHERS, SOCIAL WORKERS, ANGANWADI WORKERS, EX-PATIENTS,ETC…) </li></ul><ul><li>THEY ARE KNOWN AS “DOTS AGENT” </li></ul><ul><li>PAID AN INCENTIVE OF RS.150 PER PATIENT COMPLETING THE TREATMENT </li></ul>
  9. 9. <ul><li>SERVICES PROVIDED </li></ul><ul><li>SERVICES INC DRUGS – FREE OF COST </li></ul><ul><li>HIGH QUALITY SPUTUM MICROSCOPY WITH PROMPT REPORTING OF RESULTS </li></ul><ul><li>HIGH QUALITY EVALUATION AND APP. TREATMENT </li></ul><ul><li>HIGH QUALITY DRUGS </li></ul><ul><li>UNINTERRUPTED SUPPLY OF DRUGS TO THE FULL REQUIREMENT </li></ul><ul><li>PROVISION OF DOTS BY THE GENERAL HEALTH SERVICES OR BY COMMUNITY VOLUNTEERS </li></ul><ul><li>TECHNICAL ASSISTANCE </li></ul>
  10. 10. <ul><li>DEFAULTER ACTION </li></ul><ul><li>IF PATIENT FAILS TO REPORT VISIT HOME </li></ul><ul><li>INTENSIVE PHASE -ON NEXT DAY </li></ul><ul><li>CONTINUATION PHASE - WITHIN A WEEK </li></ul><ul><li>RECORDS </li></ul><ul><li>TUBERCULOSIS REGISTER </li></ul><ul><li>LABORATORY REGISTER </li></ul><ul><li>TREATMENT CARD </li></ul><ul><li>LABORATORY FORM FOR SPUTUM EXAMINATION </li></ul><ul><li>SUPERVISORY REGISTER </li></ul><ul><li>REFERRAL FOR TREATMENT REGISTER </li></ul><ul><li>REPORTS </li></ul><ul><li>QUARTERLY REPORTS ON </li></ul><ul><li>-CASE FINDING </li></ul><ul><li>-SPUTUM CONVERSION </li></ul><ul><li>-RESULTS OF TREATMENT </li></ul><ul><li>RNTCP REPORT ON PROGRAMME MANAGEMENT & LOGISTICS </li></ul>
  11. 11. RNTCP-PHASES PHASE I (1992 – 2006) PHASE II ( 2006 – 2011 )
  12. 12. <ul><li>PHASE I </li></ul><ul><li>BY 1993 </li></ul><ul><li>PILOT PHASE I </li></ul><ul><li>PILOT PHASE II </li></ul><ul><li>PILOT PHASE III </li></ul><ul><li>BY THE END OF 1998, ONLY 2 % COVERED. </li></ul><ul><li>BY 2006 WHOLE POPULATION COVERED. </li></ul>
  13. 13. <ul><li>PHASE II </li></ul><ul><li>TO CONSOLIDATE, MAINTAIN AND FURTHER IMPROVE THE ACHIEVEMENTS OF THE PHASE I </li></ul><ul><li>ACTIVITIES </li></ul><ul><li>INCREASE ACCESS OF SERVICES TO HARD-TO-REACH AREAS </li></ul><ul><li>STRENGHTHENING THE INTER SECTORAL COLLABORATION </li></ul><ul><li>SCALLING UP OF THE STATE LEVEL INTERMEDIATE REFERRAL LABORATORIES(IRL) CAPACITY </li></ul><ul><li>IMPLEMENTATIOIN OF DOTS-PLUS FOR MDR-TB CASES IN A PHASED MANNER </li></ul><ul><li>DISRIBUTION OF PAEDIATRIC DRUG BOXES </li></ul><ul><li>INSTITUTIONAL STRENGHTHENING AT NATIONAL, STATE AND DISTRICT LEVEL </li></ul><ul><li>INTRODUCTION OF TB-HIV CO-ORDINATOR ,URBAN CO-ORDINATOR AND COMMUNICATION FACILITATOR. </li></ul>
  14. 14. DRUG RESISTANCE SURVEILLANCE AIM TO DETERMINE THE PREVALENCE OF ANTI-MYCOBACTERIAL DRUG RESISTANCE AMONG -NEW CASE -TREATED CASE PLANS STATE WIDE DRS SURVEYS ICMR SURVEYS BY 2010, A NETWORK OF 24 STATE-LEVEL CULTURE AND DRUG SENSITIVITY TESTING LABORATORIES
  15. 15. DOTS-PLUS STRATEGY CURRENTLY UNDER DEVELOPMENT BY WHO FOR THE MANAGEMENT OF MDR-TB CASES GOAL TO PREVENT FURTHER DEVELOPMENT OF MDR-TB PRE-REQUISITE AN EFFECTIVE DOTS BASED TB CONTROL PROGRAM ORGANISATION DESIGNATED RNTCP DOTS-PLUS SITES ATLEAST 1 IN EACH STATE WITH READY ACCESS TO RNTCP ACCREDITED CULTURE AND DRUG SUSCEPTIBILITY TESTING(DST) LABORATORY
  16. 16. <ul><li>WHO 7-POINT PLAN OF ACTION </li></ul><ul><li>SHORT TERM </li></ul><ul><li>BASIC TB CONTROL MEASURES MEET INTERNATIONAL STANDARD FOR TB CARE </li></ul><ul><li>RAPID SURVEYS TO ACCESS THE DISTRIBUTION OF MDR-TB AND XDR-TB IN VULNERABLE POPULATION </li></ul><ul><li>STRENGTHEN NATIONAL TB LAB CAPACITY </li></ul><ul><li>IMPLEMENTING INFECTION CONTROL PRECAUTIONS IN HEALTH CARE FACILITIES </li></ul><ul><li>LONG TERM </li></ul><ul><li>ESTABLISH CAPACITY FOR CLINICAL AND PUBLIC HEALTH SERVICES </li></ul><ul><li>PROMOTE UNIVERSAL ACCESS TO ARTs FOR TB-HIV PARIENTS </li></ul><ul><li>FUNDING FOR RESEARCHES </li></ul>
  17. 17. <ul><li>MANAGEMENT OF PAEDIATRIC TUBERCULOSIS </li></ul><ul><li>DIAGNOSIS AND TREATMENT FOR THE PAEDIATRIC PATIENTS </li></ul><ul><li>ISSUING DRUGS FOR THE PAEDIATRIC CASES IN THE PATIENT WISE BOXES(PWB) </li></ul><ul><li>TREATMENT BASED ON CHILD’S BODY WEIGHT </li></ul><ul><li>6-10KG WEIGHT BAND </li></ul><ul><li>11-17KG WEIGHT BAND </li></ul><ul><li>CHILDREN WEIGHING  6KG WILL BE TREATED WITH LOOSE ANTI-TB DRUGS </li></ul>
  18. 18. <ul><li>TB HIV CO-ORDINATION </li></ul><ul><li>RNTCP AND NACO – “JOINT ACTION PLAN” </li></ul><ul><li>OBJECTIVE </li></ul><ul><li>TO REDUCE TB ASSOCIATED MORBIDITY AND MORTALITY IN TB-HIV PATIENTS </li></ul><ul><li>FOR EFFECTIVE PREVETION AND CONTROL OF BOTH THE DISEASES </li></ul><ul><li>PHASE I </li></ul><ul><li>2OOI </li></ul><ul><li>IN 6 HIGH HIV PREVALENT STATES(AP, KARNATAKA, MAHARASHTRA, MANIPUR, NAGALAND, TN) </li></ul><ul><li>PHASE II </li></ul><ul><li>2003 </li></ul><ul><li>8 ADDITIONAL STATES(DELHI, GUJARAT, HP, KERALA, ORISSA,PUNJAB, RAJASTHAN, WB) </li></ul><ul><li>PLAN TO BE EXTENDED TO ALL OTHER STATES IN DUE COURSE </li></ul>
  19. 19. <ul><li>ACHIEVEMENTS OF RNTCP </li></ul><ul><li>TREATMENT SUCCESS RATE </li></ul><ul><li>DEATH RATE </li></ul><ul><li>INVOLVEMENT OF NGOs, </li></ul><ul><li> PRIVATE PRACTITIONERS, </li></ul><ul><li> MEDICAL COLLEGES, </li></ul><ul><li> PERIPHERAL LABORATORIES, </li></ul><ul><li> DESIGNATED MICROSCOPY CENTRES, </li></ul><ul><li> PUBLIC HEALTH CARE PROVIDERS </li></ul><ul><li>4 URBAN DOTS PROJECTS(MUMBAI,HYDERABAD,VARANASI,CHENNAI) </li></ul><ul><li>“ NATIONAL FRAME WORK FOR JOINT TB-HIV COLLOBORATIVE ACTIVITIES” </li></ul><ul><li>- BY CENTRAL TB DIVISION & NACO </li></ul><ul><li>- REPLACES “JOINT ACTION PLAN” </li></ul>
  20. 20. <ul><li>NATIONAL FRAMEWORK FOR JOINT TB-HIV COLLABORATIVE </li></ul><ul><li>ACTIVITIES </li></ul><ul><li>ESTABLISHMENT OF CO-ORDINATION MECHANISMS,JOINT PLANNING AND REVIEW AT NATIONAL,STATE AND DISTRICT LEVELS </li></ul><ul><li>SERVICE DELIVERY CO-ORDINATION </li></ul><ul><li>INVOLVEMENT OF NGOs </li></ul><ul><li>OPERATIONAL RESEARCH </li></ul><ul><li>INFECTION CONTROL MEASURES </li></ul>
  21. 21. STOP TB STRATEGY VISION A WORLD FREE OF TB GOAL TO DRAMATICALLY REDUCE THE GLOBAL BURDEN OF TB BY 2015 IN LINE WITH THE MILLENNIUM DEVELOPMENT GOALS AND THE STOP TB PARTNERSHIP TARGETS
  22. 22. <ul><li>COMPONENTS </li></ul><ul><li>HIGH QUALITY DOTS EXPANSION </li></ul><ul><li>ADDRESSING TB-HIV, MDR-TB AND OTHER CHALLENGES </li></ul><ul><li>HEALTH SYSTEM STRENGHTHENING </li></ul><ul><li>ENGAGING ALL CARE PROVIDERS(PUBLIC-PUBLIC AND PUBLIC- </li></ul><ul><li>PRIVATE MIX APPROACHES) </li></ul><ul><li>EMPOWERING PEOPLE WITH TB CARE </li></ul><ul><li>PROMOTING RESEARCH ACTIVITIES </li></ul>TARGETS - BY 2015 GLOBAL BURDEN OF TB(PREVALENCE AND DEATH RATES) WIL BE REDUCED BY 50 % (INCL TB-HIV CASES) - BY 2050 GLOBAL INCIDENCE OF TB  1 CASE PER 1 MILLION POPULATION PER YEAR
  23. 23. <ul><li>IMPROVED TREATMENT ACCESS </li></ul><ul><li>NEW DRUGS </li></ul><ul><li>NEW VACCINE - DEVELOP A SAFE, AFFORDABLE VACCINE TO IMPROVE UPON THE EXISTING VACCINE </li></ul><ul><li>NEW DIAGNOSTICS- TO DEVELOP EFFICIENT, EFFECTIVE, AND AFFORDABLE DIAGNOSTIC TESTS FOR TB </li></ul>GLOBAL PLAN TO STOP TUBERCULOSIS AIMS
  24. 25. ACKNOWLEDGEMENT <ul><li>PROF. HOD. DR. UMADEVI MADAM, SPM DEPT AND ALL OUR PROFESSORS. </li></ul><ul><li>TUBERCULOSIS CENTRE, PULIANTHOPE. </li></ul><ul><li>CHETPET TB HOSPITAL. </li></ul><ul><li>DOTS CENTRE, KMCH AND ROYAPETTAH. </li></ul><ul><li>THIRUVOTTESWARAR TB HOSPITAL, OTTERI. </li></ul><ul><li>AYNAVARAM DOTS CENTRE. </li></ul>

×