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National Tuberculosis Elimination Programme.pptx
- 1. National Tuberculosis EliminationProgramme (NTEP) Facilitator : Dr.Manisha Gohel Presenter: Dr.Darshna Sarvaiya , Third Year Resident Department of Community Medicine
- 2. • To describemagnitude of TB Problem • To explain evolution of TB Control Strategies in India • To enlist goals, objectives of NTEP • To summarize newer initiatives under NTEP Objectives
- 3. Tuberculosis (TB) isan infectious disease caused by the bacterium Mycobacterium tuberculosis (MTB) Tuberculosis generally affects the lungs, but can also affect other parts of the body One patient with infectious pulmonary TB if untreated can infect 10-15 persons in a year What is Tuberculosis ?
- 4. o Malnutrition o Diabetes oHIV infection o Low body weight o Severe kidney disease o Other lung diseases (silicosis) o Substance abuse etc. o Overcrowding o Inadequate ventilation o Enclosed living/working conditions o Occupational risks Environmental Medical Risk Factors
- 5. India is thehighest TB burden country • India - 26% • Indonesia – 10% • China – 10% • Nigeria – 06% • South Africa – 04% • Pakistan – 03% Total 60% global burden of TB disease lies within 6 countries TB High Burden Countries
- 6. The TB threatis REAL in India 10 million people fell ill from TB 1.4 million people died from TB 4.6 lakh people had drug- resistant TB Missing million TB patients 1 patient dies every minute Less than 50% treated successfully WHO Global TB Report 2020
- 7. TB Notification Progressunder NTEP WHO Global TB Report 2020
- 8. National Tuberculosis ControlProgramme (NTCP) (1962 – 1997) Revised National Tuberculosis Control Programme ( RNTCP) (1997 – 2020) National Tuberculosis Elimination Programme (NTEP) ( 2020 – till date)
- 9. The India’s Tuberculosis(TB) control programme got rechristened to National Tuberculosis Elimination Programme (NTEP) from Revised National Tuberculosis Control programme Programme (RNTCP) on 1st January , 2020 Transition from RNTCP NTEP
- 10. • India hascommitted to end TB by 2025, 5 year ahead of the global SDG target • Prime Minister of India launched TB free India campaign at “Delhi End TB Summit” on 13th March, 2018 • The campaign calls for a social movement focused on patient – centric and holistic care driven by integrated actions for TB free India TB Free India Campaign
- 11. • To reducemortality and morbidity From TB • To interrupt chain of transmission until TB ceases to be a public health problem in India Goals
- 12. • To reduceincidence of TB and mortality due to TB • To prevent emergence of drug resistance and effectively manage drug – resistance TB • To improve outcomes among HIV – infected TB Patients • To decentralize and align RNTCP management units with NHM block level units within general health system Objectives – to achieve TB Free India
- 13. India: MDG6 TBtarget TB REVERSED Rate per 100,000 population 50% 35 lakh additional lives saved 50% New cases declining All cases reduced by half Deaths reduced by half HIV WHO Global TB Report 2016 465 195 per lakh pop (58% reduction) 38 17 per lakh pop (55% reduction) 216 167 per lakh pop (23% reduction)
- 14. Vision: A worldfree of TB Zero TB deaths, Zero TB disease, and Zero TB suffering Goal: End the Global TB Epidemic (<10 cases per 100,000 population) Sustainable Development Goals (SDG) INDICATORS TARGETS SDG 2030 Reduction in number of TB deaths compared with 2015 (%) 90% Reduction in TB incidence (new case) rate compared with 2015 (%) 80% TB-affected families facing catastrophic expenditures due to TB (%) Zero
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- 16. Infrastructure Scale Up TBMicroscopy Centre Molecular Testing Lab Financial Allocation
- 17. Mitigation Measures duringthe pandemic • Directives for uninterrupted TB Services • Bi – directional TB – COVID Screening • Telemedicine and Active Case Findings (ACF) • Scale up of Platform technologies • PPEs for staff & door – step sample collection and delievery of drugs • Timely release of benefits under Nikshay Poshan Yojana • E – trainings and periodic review with States / Districts at all levels Achievements – 2020 • HIV Status known: 92% • UDST Offered: 67 % • Treatment Success Rate : 82% • DR TB Treatment Initiation : 86% • Nikshay Poshan Yojana Paid : 62%
- 18. Strengthening Case Findings •Population Levels Screening followed by Active Case Finding among Vulnerable & comorbid • Extrapulmonary diagnosis Medical College involvement • Decentralizing TB Services to HWCs • Intensified Case Findings in other OPDs like NCD / HIV • Mandatory Notification – Gazette • Schedule H 1 Surveillance • Incentives for providers and informants Public Private
- 19. TB MUKT BHARAT JanuaryActive Case Findings February Orienting Elected Representatives on TB March World TB Day April Engaging Communities through – HWCs May TB Free Workplaces June TB & Women July Engaging Religious Leaders & PRIs August TB Prevention & Lung Health September TB & Nutrition October Engaging Children & Youth November TB Camps December Stigma Mitigation
- 20. Subnational Certification ofTB Free Status
- 21.
- 22. Community Engagement National TBForum State TB Forum District TB Forum Block TB Forum TB Champion & Patient Support Group • National TB Forum Constituted with Civil Society as Co – Chair and with other ministries • All State & District TB Forum constituted • More than 1200 TB Champions sensitized • Regional Review Meetings conducted
- 23. Key Priorities :2021 Inter Sectoral Coordination in TB Response ( Like COVID – 19 ) Sustaining the COVID Appropriate Behavior Scale Up of Preventive Treatment – Household / Community / Facility level Decentralization of TB services through HWCs People’s Movement – “TB MUKT BHARAT”
- 24. Key Services 1. Freediagnosis and treatment for TB patient 2. Provision of rapid diagnostics 3. Testing of all TB patients for drug resistance and HIV 4. Management of associated diseases 5. Treatment adherence support 6. Nutrition assistance to TB patient
- 26. Treatment Treatment Patient Centric Care ReduceOut-of-pocket Expenditure • Daily Regimen • Shorter Regimen • Newer Drugs • IT Enabled Adherence Support • Comorbidity management • Direct Benefit Transfer
- 27. • Incentives ofRs. 1000 for notification and reporting treatment outcome will be given in two installments (Private Practitioner) - Rs. 500/- at notification of TB Patients - Rs. 500/- at reporting treatment outcome • New case : Rs. 1000 /- at completion of treatment (Government) • Previously treated Case : Rs. 1500/- at completion of treatment • Drug Resistance Case: Rs. 2000/- at completion of intensive phase, Rs. 3000/- at completion of treatment Incentives to providers
- 28. • Active TBCase finding in vulnerable population • CBNAAT expansion • Increased notification of TB Patients from private sector • Daily regimen implementation for treatment of TB • Universal Drug Susceptibility Testing • Newer Drugs – Bedaquiline & Delamanid • Direct benefit transfer scheme • NIKSHAY Enhancement – NIKSHAY Aushadhi Newer Initiatives
- 30. Bending the Curve Acceleratingtowards a TB free India Thank You …..!
Editor's Notes
- #5 Anyone can become infected with TB simply by breathing in the germs Once infected, the chances of developing active disease increases when the immunity goes down due to Babies and young children often have weak immune systems which increases their susceptibility to TB