Newer initiatives of rntcp
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The document summarizes newer initiatives of the Revised National Tuberculosis Control Programme (RNTCP) in India. It discusses the introduction of newer rapid diagnostic tests like CBNAAT and GeneXpert, abolishing of category 2 patients, use of newer drugs for drug resistant TB, introduction of daily treatment regimens in different weight bands, and establishment of Nikshay for electronic notification of TB cases. It also discusses initiatives like 99DOTS for treatment adherence, intensified case finding, incentives for private providers, making non-declaration of TB a punishable offense, and nutritional support through Nikshay Poshan Yojana. The document concludes with references for further information.
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- Tuberculosis is an infectious disease caused predominantly by Mycobacterium tuberculosis that commonly affects the lungs but can affect any part of the body. India accounts for one fourth of the global TB burden with over 6000 new cases and 600 deaths daily.
- The Revised National Tuberculosis Control Programme was launched in 1997 based on the WHO DOTS strategy and aims to achieve at least 85% cure rates through direct observation of treatment. It utilizes sputum microscopy, culture and drug susceptibility testing, chest x-rays, and more recently molecular diagnostics to detect TB.
- Drug resistant TB including multi-drug resistant TB has emerged as a major challenge for the programme. The Programmatic Management of Drug Resistant TB was
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The document provides an overview of the Revised National Tuberculosis Control Program (RNTCP) in India. It discusses the evolution of tuberculosis (TB) control efforts from the National TB Program (NTP) to the RNTCP, which adopted the internationally recommended DOTS strategy in 1997. The organizational structure and operational guidelines of the RNTCP are also summarized. Key aspects covered include diagnostic algorithms, treatment guidelines, drug regimens, and monitoring of treatment outcomes. Special considerations for managing TB in vulnerable groups are also highlighted.
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The document outlines new guidelines for TB control in India, including changes to diagnostic algorithms, case definitions, treatment regimens, and follow-up procedures. Key changes include implementing a daily drug regimen using fixed-dose combinations based on weight bands, removing the need to extend the intensive phase, and conducting long-term clinical and laboratory follow-up of patients for up to two years after completing treatment. The guidelines also provide new diagnostic and treatment approaches for drug-resistant TB, intensified case finding for vulnerable groups, and ICT-enabled adherence monitoring tools.
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Revised National Tuberculosis Control Programme
The Revised National Tuberculosis Control Programme (RNTCP) aims to achieve universal access to TB control services and a TB-free India. It evolved from the National TB Programme starting in the 1950s and was revised in 1998 with the Directly Observed Treatment, Short-course strategy. The RNTCP objectives are to achieve 85% cure rates and detect 70% of cases. Implementation in Community Health Centers, Primary Health Centers and Sub-Centers includes establishing microscopy centers, providing equipment and drugs, treating patients, and ensuring quality control. The programme has successfully treated over 10 million patients since 1998.
Diagnosis and management of tuberculosis with revised rntcp
The document provides guidelines for the diagnosis and management of tuberculosis (TB) according to the Revised National Tuberculosis Control Programme (RNTCP). It discusses definitions of TB cases, classification based on treatment history, diagnostic methods, treatment regimens for pulmonary and extra-pulmonary TB, management of drug-resistant TB, and follow-up procedures. Key changes in the recent guidelines include introducing a daily treatment regimen for both new and previously treated TB cases, as well as additional guidance for diagnosing and treating multi-drug resistant TB.
RNTCP-ASHUTOSH.pdf
This document outlines the presentation on the Revised National Tuberculosis Control Programme given by Ashutosh Sharma. It discusses tuberculosis including its causes, risk factors, signs and symptoms, diagnostic methods, and treatment protocols. It provides details on the National Tuberculosis Programme established in 1962 and the Revised National Tuberculosis Control Programme implemented in 1997 using the WHO recommended DOTS strategy. The presentation covers goals and strategies of RNTCP including improved case detection and cure rates. It also discusses the National Tuberculosis Elimination Programme and initiatives like Nikshay Poshan Yojna.
Rntcp and national strategic plan(nsp) for tb
After the successful NSP 2017-2025,Goi is lauching NSP 2017-2025 for elimination of TB on 24th march( World TB day ) 2017. Module is on MOHFW site but i have try to keep it brief,hope its ll be useful specially for academic and administrative purposes.
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REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)
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Newer initiatives of rntcp
- 1. PRESENTED BY- DR. Santosh Kr Soren. (JRA-3) DEPT. OF PSM RIMS, RANCHI. Newer Initiatives of RNTCP Venue: Seminar Hall Time :30min 1
- 2. Newer Initiatives of RNTCP • Introduction of CBNAAT/ Gene-Expert for diagnosis of TB. • Category 2 abolished on 18/12/18 and cat 2 patient (R/D/F) are now included in cat 1. • All MDR-TB cases would be subjected to liquid culture & drug sensitivity test at baseline for fluoroquinolones and second line injectables. • Introduction of newer bactericidal drug like Bedaquiline and Delamanid for MDR & XDR. 2
- 3. • Introduction of daily regimen in 4 weight band for adult which is recently changed on date 14/05/19 into 5 weight band and for pediatric 6 weight band is there. • To support TB notification and Strengthen TB surveillance, a case based, web based TB notification system Nikshay was established to provide platform for recording and reporting from both public and private sectors. 3
- 4. • 99 DOTS is a ICT enabled solution for patient centric adherence support. • Intensified TB case finding by door to door visit in communities or vulnerable population. • After completion of the treatment, follow up of the patient should be done on 6,12,18 & 24 month by clinical and sputum examination. 4
- 5. • Incentive for private doctor on successful completion of treatment is 1000 rupees and 750 rs given to patient on treatment completion in hilly/ tribal areas. • Non declaration of TB is now a punishable offence under IPC 269,270 in which there can be imprisonment from 6 months to 2 years. • Nikshay Poshan Yojna (NPY) in which patient gets 500 Rs/month for nutritional support throughout the duration of treatment of TB. • “End TB by 2025” declared by P.M of India on Delhi TB Summit on 13th march 2018. 5
- 6. Recent Guidelines for Daily Regimen • Daily regimen for both new and previously treated cases and duration is 6 month(2+4) started in whole country since October 2017. • Addition of Ethambutol in C.P phase. • FDC available in 5 weight bands for adult and 6 weight bands for children. • No need for extension of IP phase in DS- TB. • For both new and retreated cases CP may be extended by 3-6 month in CNS or Skeletal or Disseminated TB. • Loose individual ATT drugs may be needed as substitution in case of ADR or with co-morbid condition. 6
- 7. 7
- 8. Real-Time Medication Event Reminder-Monitor Device (RT-MERM) • The RT-MERM technology (i) is highly accurate, affordable, re-usable, and suitable for TB medications, (ii) provides programmable visual and audible reminders of daily dosing and of monthly refill, and (iii) compiles and transmits automatically detailed, and patient-specific information regarding medication taking and medication adherence. 8
- 9. 9
- 10. • This reminder-monitor utilizes an innovative two-part, consisting of a container (the “Container”) that will hold the patient’s medications and a small electronic module housed within the Container (the “Monitoring Technology”) that will transmit captured information. When the Container is opened, it records the date and time of each such medication taking event, store the date/time data, and automatically transmits (via integrated, affordable 2G data transmission capability) such date/time dosing information for centralized collection, analysis, and use by health care providers via systems such as eNikshay or 99DOTS. 10
- 11. References • National Strategic Plan for Tuberculosis Control 2017–2025; RNTCP • Tbcindia.gov.in • TB FACTS.ORG; Information about Tuberculosis • TB India 2018; Annual Status Report • Global Tuberculosis Report 2018 by WHO • Standards for TB Care in India Manual by WHO. • K. Park PSM text book. • D.K. Taneja Programme book. 11