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7.Rntcp
 

7.Rntcp

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    7.Rntcp 7.Rntcp Presentation Transcript

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