The National Tuberculosis Control Programme and Revised National Tuberculosis Control Programme were implemented in India to deal with the tuberculosis problem. The objectives are to reduce infection rates through case detection, treatment, and BCG vaccination. In the 1990s, the programmes suffered from management issues and inadequate funding. The RNTCP adopted the DOTS strategy recommended by the WHO to improve cure rates and case detection through direct observation of treatment. Treatment involves a two-phase regimen administered under direct observation at least initially. Nurses play an important role in treating TB patients through home visits, education, and contact screening.

3. National
Tuberculosis
Control
Programme

4. Objectives:-
The objectives of NTCP are as follows:
1) To deal with the problem of tuberculosis
through integrated health services.
2) To give priority to the reduction of pool of
infection, to case detection, treatment of cases
and drug distribution.
3) To give BCG vaccination to susceptible.

5. In 1992 Govt. of India along with WHO & SIDA
received the TB situation in the country & came up
with following conclusions:
NTP though technically sound, suffered from
managerial weakness.
Inadequate funding.
Over reliance on X-ray for diagnosis.
Frequent interrupted supply of drugs.
Low rate of treatment completion.

7. Objectives:
The objectives of RNTCP are:
Achievement of at least 85% cure rate of
infectious cases of tuberculosis; though
DOTS involving peripheral health
functionaries.
Augmentation of case finding activities
through quality sputum microscopy to
detect at least 70% of estimated cases.

8. ORGANIZATION:-
The profile of RNTCP in a state is as follows:
State Tuberculosis Office State Tuberculosis Officer
State Tuberculosis Training Director
& Demonstration Centre
District Tuberculosis Centre District Tuberculosis Officer
Tuberculosis Unit Medical Officer- TB Control
Senior Treatment Supervisor
Senior TB laboratory
supervisor

9. By the end of 1998, only 2% of total population
of India was covered by RNTCP. Large scale
implementation began in late 1998. The
RNTCP has rapidly over the years and since
March 2006, it covers the whole country.
DOTS strategy adopted by Revised National TB
Control Programme.

11. DOT THERAPY
 Direct Observed Treatment is WHO recommended
strategy emphasizes for global T.B. control.
This strategy emphasizes adequate and efficient
diagnosis and treatment.
It means short course chemotherapy given under
direct observation to at least all identified smear
positive T.B. cases.
Globally the DOT strategy has been recognized as
the best approach to achieve a decrease in the
disease burden and a reduction in the spread of
infection.

12. BENEFITS:-
Dots more than doubles the accuracy of TB
diagnosis.
Dots results in success rates upto 95%.
Dots prevent the spread of tuberculosis bacilli,
thus reducing the incidence and prevalence of
TB.
Dots helps in alleviating poverty by saving lives,
reducing the duration of illness and presenting
new infectious case.

13. Contd…
Dots improve the quality of care and
overcomes stigma.
Dots prevents treatment failure and the
emergence of MDR-TB by ensuring patient
adherence and an un interrupted supply of
Anti-TB drug.
Dots lends credence to TB control efforts.
Dots provides a model for strengthening
health services.

15. Treatment under DOTS:-
The WHO recommended treatment regimen for
DOTS short course chemotherapy. It is divided into
two phases the intensive and continuation phase.
 In intensive phase(2-3 months), each dose
given thrice a week is administered under direct
observation.
 In the continuation phase(4-5 months), at
least one of thrice a week doses is administered
under direct observation.
The actual treatment regimen and duration
depend on the category of treatment of patient.

16. Category of
Treatment Type of Patient
Regimen
Categry-1
New sputum smear positive.
Seriously ill sputum smear
negative
Seriously ill extrapulmonary
2(HRZES)3
4(HR)3
Category-2
Previously treated
Sputum smear +ve relapse
Sputum smear –ve failure
Sputum smear+ve treated
After default
2(HRZES)3/
1(HRZE)3/
5(HRE)3
Category-3
New sputum smear –ve not
seriously ill extrapulmonary
Not seriously ill.
2(HRZ)3/
4(HR)3

18. ROLE OF NURSE IN CARE OF T.B. PATIENT
Tuberculosis is a social problem. A T.B.
patient and family are very sensitive and
do not wish their neighbours to know
about the presence of T.B. in the family.
T.B. is a chronic long lasting disease,
hence most of the cases are treated at
home. A nurse must keep in mind the
principles of home visiting and priortising
the case selection and care of the patient
at home.

19. • Motivate the patient to take regular treatment,
when the patient defaults in taking drugs, a visit
must be paid and repeated till the patient becomes
regular
• In case of newly diagnosed patients, visit
the home for initial motivation, instituting
procedures designed to care for the patient and to
prevent the spread of infection.
• Frequent visit to the patients to ensure
the proper disposal of sputum and precautions
regarding protection of other members.

21. Contact Examination:-
• All household contact must be advised for
screening for exposure by the X-ray chest, sputum
test and Mantaux test.
• If the members do not show any infection,
they can be given BCG and those who show early
sign of infection, may be treated by small dose of
Isoniazid(INH) and thiacetazone etc.

25. BIBLIOGRAPHY:-
1. Park.K, “Parks Text Book of preventive and social
medicine”, 22nd edition,Banarsidas bganot
Publishers,(M.p.) India, Pp-394-400
2. Gulani K.K , “Community Health Nursing”, 2nd
edition,Kumar Publishing Home,Delhi,Pp-673-683.
3. Swarnkar Keshab , “Community Health Nursing, 2nd
edtion, N.R. Publishers, Pp-612-615.
4. www.tbcindia.com