This document summarizes the key activities and findings of Nepal's National Tuberculosis Program. It outlines the program's vision, goals, and objectives to reduce TB incidence, mortality and transmission. It provides data on TB case notifications, treatment success rates, and drug-resistant TB detection and treatment outcomes. It also summarizes findings from Nepal's 2018-19 National TB Prevalence Survey, which found the TB burden is higher than previously estimated. The document concludes with achievements of the program and priorities for the way forward, including improving access to quality TB services and ensuring high-level political commitment.
Tuberculosis National Health Program in Nepal Public Health
The document summarizes Nepal's National Tuberculosis Program. It outlines the program's vision, goals, and activities in fiscal year 2075/76, including providing treatment to 32,043 TB cases and maintaining a treatment success rate above 90%. It also discusses challenges such as lack of focal persons at local levels and inadequate training. Moving forward, the program aims to expand community support and public-private partnerships to improve TB prevention and care.
Global TB burden updates provide information on the TB situation globally and in India. Key points include:
- India accounts for over a quarter of the global TB burden, with an estimated 28 lakh incident cases in 2016 and 4.2 lakh deaths.
- WHO has revised their estimates of India's TB burden upwards based on new evidence, though the trend still shows a decline in incidence and mortality.
- India has achieved the MDG target of reducing prevalence and mortality by 50%, but a huge burden remains, especially among economically productive groups.
- The government of India's strategic vision is to achieve a TB-free India by 2025 through universal access to quality diagnosis and treatment.
National TB prevalence survey results and its implications for NTEP policiesRivu Basu
The national TB prevalence survey in India found:
1) The prevalence of microbiologically confirmed pulmonary TB among those aged 15 and older was 316 per lakh population.
2) The prevalence was highest in older age groups, males, malnourished individuals, smokers, alcohol users, and those with diabetes or a past history of TB treatment.
3) The prevalence:notification ratio was 2.84, indicating that for every notified TB case, 1.8 cases are missed by the public health system. Improving screening and diagnostic methods like chest x-rays could help detect additional missing cases.
The document summarizes the evolution of tuberculosis (TB) control in India from 1962 to the present. It describes how the National TB Programme (NTP) was established in 1962 but only diagnosed 30% of estimated cases and treated 30% successfully. This led to the launch of the Revised National TB Control Programme (RNTCP) in 1993, which was scaled up nationally from 1998 onwards and covered the entire country by 2006. The RNTCP implemented the DOTS strategy with a goal of reducing TB mortality and interrupting transmission through improved case detection and treatment success rates.
1) India has a high burden of tuberculosis, accounting for nearly 1/4 of global TB cases. The social and economic costs of TB in India are also high, with estimated indirect costs of $3 billion and direct costs of $300 million annually.
2) The National Tuberculosis Program (NTP) was implemented in 1962 but had low treatment success rates of only 30%. The Revised National Tuberculosis Control Program (RNTCP) was launched in 1993 using the WHO-recommended DOTS strategy.
3) RNTCP has expanded coverage to the entire country and achieved targets of 70% case detection and 85% treatment success rates. It has contributed to reducing prevalence and mortality rates of TB in India
This document summarizes key points from a clinical workshop on HIV and Hepatitis held in Nepal in November 2018. It discusses Nepal's goals of ending the AIDS epidemic by 2030 through strategies like increasing HIV testing and treatment. Testing and treatment access remains low for key populations like female sex workers, transgender individuals, and injecting drug users. The workshop covered improving screening, expanding access to pre-exposure prophylaxis and antiretroviral treatment, and transitioning from preventing mother-to-child transmission to eliminating it.
India has a large tuberculosis (TB) disease burden, with over 2 million new cases annually according to WHO. The Revised National Tuberculosis Control Programme (RNTCP) was established in 1993 to address India's TB epidemic using the WHO-recommended DOTS strategy of diagnosis, treatment and monitoring. RNTCP has since expanded nationwide and achieved high treatment success rates. Its Phase II aims to further improve TB detection and treatment, including of drug-resistant cases and among HIV patients. RNTCP is now the world's largest DOTS program and has successfully treated over 19 million TB patients.
The document summarizes India's Revised National Tuberculosis Control Programme (RNTCP). Some key points:
- TB poses a major public health burden in India, with over 2 million estimated cases annually.
- RNTCP was launched in 1997 based on the DOTS strategy to decrease TB mortality and morbidity. Its objectives are to achieve 85% cure rates for new sputum-positive cases and detect 70% of estimated cases.
- RNTCP implements standardized treatment regimens, with drugs administered under direct observation at least during the intensive phase. This along with other measures like improved diagnostics and supervision have helped reduce TB prevalence.
- The program has expanded nationwide in phases since 1997 to achieve universal
Tuberculosis National Health Program in Nepal Public Health
The document summarizes Nepal's National Tuberculosis Program. It outlines the program's vision, goals, and activities in fiscal year 2075/76, including providing treatment to 32,043 TB cases and maintaining a treatment success rate above 90%. It also discusses challenges such as lack of focal persons at local levels and inadequate training. Moving forward, the program aims to expand community support and public-private partnerships to improve TB prevention and care.
Global TB burden updates provide information on the TB situation globally and in India. Key points include:
- India accounts for over a quarter of the global TB burden, with an estimated 28 lakh incident cases in 2016 and 4.2 lakh deaths.
- WHO has revised their estimates of India's TB burden upwards based on new evidence, though the trend still shows a decline in incidence and mortality.
- India has achieved the MDG target of reducing prevalence and mortality by 50%, but a huge burden remains, especially among economically productive groups.
- The government of India's strategic vision is to achieve a TB-free India by 2025 through universal access to quality diagnosis and treatment.
National TB prevalence survey results and its implications for NTEP policiesRivu Basu
The national TB prevalence survey in India found:
1) The prevalence of microbiologically confirmed pulmonary TB among those aged 15 and older was 316 per lakh population.
2) The prevalence was highest in older age groups, males, malnourished individuals, smokers, alcohol users, and those with diabetes or a past history of TB treatment.
3) The prevalence:notification ratio was 2.84, indicating that for every notified TB case, 1.8 cases are missed by the public health system. Improving screening and diagnostic methods like chest x-rays could help detect additional missing cases.
The document summarizes the evolution of tuberculosis (TB) control in India from 1962 to the present. It describes how the National TB Programme (NTP) was established in 1962 but only diagnosed 30% of estimated cases and treated 30% successfully. This led to the launch of the Revised National TB Control Programme (RNTCP) in 1993, which was scaled up nationally from 1998 onwards and covered the entire country by 2006. The RNTCP implemented the DOTS strategy with a goal of reducing TB mortality and interrupting transmission through improved case detection and treatment success rates.
1) India has a high burden of tuberculosis, accounting for nearly 1/4 of global TB cases. The social and economic costs of TB in India are also high, with estimated indirect costs of $3 billion and direct costs of $300 million annually.
2) The National Tuberculosis Program (NTP) was implemented in 1962 but had low treatment success rates of only 30%. The Revised National Tuberculosis Control Program (RNTCP) was launched in 1993 using the WHO-recommended DOTS strategy.
3) RNTCP has expanded coverage to the entire country and achieved targets of 70% case detection and 85% treatment success rates. It has contributed to reducing prevalence and mortality rates of TB in India
This document summarizes key points from a clinical workshop on HIV and Hepatitis held in Nepal in November 2018. It discusses Nepal's goals of ending the AIDS epidemic by 2030 through strategies like increasing HIV testing and treatment. Testing and treatment access remains low for key populations like female sex workers, transgender individuals, and injecting drug users. The workshop covered improving screening, expanding access to pre-exposure prophylaxis and antiretroviral treatment, and transitioning from preventing mother-to-child transmission to eliminating it.
India has a large tuberculosis (TB) disease burden, with over 2 million new cases annually according to WHO. The Revised National Tuberculosis Control Programme (RNTCP) was established in 1993 to address India's TB epidemic using the WHO-recommended DOTS strategy of diagnosis, treatment and monitoring. RNTCP has since expanded nationwide and achieved high treatment success rates. Its Phase II aims to further improve TB detection and treatment, including of drug-resistant cases and among HIV patients. RNTCP is now the world's largest DOTS program and has successfully treated over 19 million TB patients.
The document summarizes India's Revised National Tuberculosis Control Programme (RNTCP). Some key points:
- TB poses a major public health burden in India, with over 2 million estimated cases annually.
- RNTCP was launched in 1997 based on the DOTS strategy to decrease TB mortality and morbidity. Its objectives are to achieve 85% cure rates for new sputum-positive cases and detect 70% of estimated cases.
- RNTCP implements standardized treatment regimens, with drugs administered under direct observation at least during the intensive phase. This along with other measures like improved diagnostics and supervision have helped reduce TB prevalence.
- The program has expanded nationwide in phases since 1997 to achieve universal
The document discusses tuberculosis (TB) control programs in Nepal. It notes that TB affects thousands in Nepal each year and is the sixth leading cause of death. The National TB Program aims to diagnose 70% of new cases and cure 85% by preventing 30,000 deaths in the next five years. The program registers over 30,000 TB cases annually and follows the WHO End TB Strategy and DOTS treatment model to control the disease.
The document discusses the evolution of tuberculosis (TB) control strategies in India over time. It begins with the epidemiology of TB and risk factors. The National Tuberculosis Programme was established in 1962 but had low treatment success rates. This led to the launch of the Revised National Tuberculosis Control Programme (RNTCP) in 1997, applying the WHO DOTS strategy. RNTCP expanded coverage and introduced strategies like DOTS-Plus for multi-drug resistant TB. More recent strategies include the STOP TB strategy (2006), Universal Access to TB Care (2010), and the National Strategic Plan (2012-2017) with a goal of TB elimination.
This document provides guidelines for programmatic management of tuberculosis preventive treatment in India. It discusses India's high burden of tuberculosis infection and the goal under the National Strategic Plan to provide treatment to 95% of eligible individuals by 2023. The document reviews evidence that tuberculosis preventive treatment reduces risk of developing active TB by 60-90% and is relatively safe. It recommends the 3-month rifampin and isoniazid regimen for individuals ages 0-15 based on evidence of efficacy, safety and improved adherence compared to longer regimens. The document also provides guidance on screening and treatment approaches for high-risk groups like people living with HIV and household contacts of active TB patients.
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.
This document outlines the Revised National Tuberculosis Control Programme (RNTCP) in India. It summarizes that tuberculosis poses a major public health burden in India, accounting for 1/3rd of global cases. The National Tuberculosis Control Programme started in 1962, but failed due to low treatment completion rates and organizational issues. RNTCP was launched in 1997 with DOTS strategy, which involves directly observed treatment, short-course. RNTCP aims to reduce morbidity, mortality, and transmission of TB in India through early case detection and standardized treatment. It utilizes a decentralized organizational structure and relies on community health workers to observe treatment. If fully implemented, RNTCP aims to achieve global targets for TB control by improving cure rates and case
This document discusses strategies for eliminating tuberculosis in India. It provides background on M. tuberculosis, describes how TB spreads from infected individuals, and outlines India's national tuberculosis control program and its commitment to end TB by 2025. It also summarizes diagnostic methods, treatment regimens, vulnerable populations, and the Pradhan Mantri TB Mukt Bharat Abhiyan initiative to engage communities in supporting individuals undergoing TB treatment.
This document provides a history of tuberculosis (TB) and efforts to control it. It discusses how TB was a major cause of death in Europe and America until antibiotics were developed in the mid-20th century. Major developments in treating and preventing TB are outlined, including the BCG vaccine and various antibiotic treatments. The document also summarizes global strategies to end TB, barriers to achieving targets, and the need for new tools and political/financial commitment to eliminate TB by 2030.
1.HIV Background and Epidemiology - Copy (2).pptssuser0c2aba
The global HIV epidemic affected 36.7 million people in 2017, including 5.1 million in Asia and the Pacific region. In Nepal, there were an estimated 31,020 people living with HIV in 2017. While HIV prevalence in the general adult population remains below 1%, the epidemic in Nepal is considered concentrated among key populations such as people who inject drugs, female sex workers, and men who have sex with men. The government of Nepal has set targets to identify 90% of estimated HIV cases, treat 90% of identified cases, and retain 90% of people on antiretroviral therapy by 2020 in order to end the AIDS epidemic in the country by 2030.
- India has the highest burden of tuberculosis (TB) in the world, accounting for over 20% of global TB cases.
- The National Strategic Plan for TB Control aims to achieve universal access to quality TB diagnosis and treatment through intensified case finding, improved diagnosis rates, and expanded access to treatment, including for drug-resistant TB and HIV/TB co-infection.
- New diagnostic technologies like molecular diagnostics, urine lipoarabinomannan tests, and breathalyzer tests have improved TB detection rates. The shorter daily drug regimen has also improved treatment outcomes.
- Initiatives to address TB among high-risk groups like people with diabetes, tobacco users, and in private healthcare settings have expanded
This document summarizes the current situation of leprosy in India and discusses future implications. It notes that while prevalence has decreased due to efforts like the National Leprosy Eradication Program, India still accounts for 60% of new global cases each year. The national strategy now focuses on active case detection campaigns in highly endemic areas, increasing awareness to reduce stigma, and exploring preventive approaches like chemoprophylaxis to break transmission chains and reach zero disease status. A single dose of rifampicin administered to contacts has shown up to 57% reduced risk of developing leprosy and is part of the current leprosy post-exposure prophylaxis program.
India has moved from a tuberculosis (TB) control program to eliminating TB through its National Strategic Plan for TB Elimination (2017-2025). Key challenges include engaging private providers, addressing drug-resistant TB, and preventing new TB cases. The plan aims to reduce TB incidence and mortality by 80% and 90% respectively by 2025. Strategies include engaging private providers, active case finding, addressing social determinants, and a multisectoral approach. The government's digital Nikshay program tracks TB cases and outcomes nationwide to support elimination goals.
Global tuberculosis rates have declined significantly since 1990. 56 million patients have been successfully treated and 22 million lives have been saved since 1995. The TB mortality rate has declined 45% globally since 1990. However, TB remains one of the top three killers of women worldwide. In 2012, there were an estimated 530,000 TB cases among children and 74,000 TB deaths among HIV-negative children. Treatment success rates have improved dramatically from 69% in 2000 to 87% in 2011. Despite progress, many TB cases are still being missed due to lack of diagnosis. In 2012, only 66% of the estimated 8.6 million incident TB cases were detected and notified. Multidrug-resistant TB also remains a major public health crisis,
Revised national tuberculosis control programmeRavi Rohilla
This document provides an overview of tuberculosis (TB) control in India. It discusses the background and epidemiology of TB globally and in India. It describes India's National TB Control Programme established in 1962 and the Revised National TB Control Programme (RNTCP) launched in 1997, which applies the WHO-recommended DOTS strategy. The RNTCP aims to achieve 85% treatment success among new sputum-positive TB patients and detect at least 70% of estimated cases. It emphasizes standardized treatment regimens, quality-assured diagnosis, and direct observation of treatment.
Epidemiology of tb with recent advances acknowledged by whoRama shankar
This document provides an overview of tuberculosis epidemiology and recent advances in tuberculosis programs. It discusses the global and national burden of tuberculosis, the evolution of tuberculosis control programs in India including the National Tuberculosis Control Programme and Revised National Tuberculosis Control Programme. It covers diagnosis, treatment, drug-resistant tuberculosis, tuberculosis and HIV coinfection, and recent advances acknowledged by the WHO. The post-2015 tuberculosis strategy in relation to sustainable development goals is also mentioned.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Annette Verster, WHO
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
1. Tuberculosis infection is highly prevalent in India, with an estimated 35-40 crore people infected, and 26 lakh estimated to develop TB disease annually. 2% of household contacts of active TB patients in a recent Indian study developed TB disease within 2 years.
2. Targeted testing for TB infection and provision of preventive treatment can significantly reduce the risk of developing active TB, by 60% on average and up to 90% for people living with HIV. Effective implementation of preventive treatment could reduce annual TB incidence in India by 8.3% based on modeling.
3. The National TB Elimination Program in India has issued guidelines for programmatic management of TB preventive treatment to help reduce
The document summarizes India's Revised National Tuberculosis Control Programme (RNTCP). It was established in 1992 by the government of India, WHO and World Bank in response to high TB mortality in India. The goal is to reduce mortality and interrupt transmission of TB. The strategy includes achieving at least 85% cure rates for infectious cases and detecting at least 70% of estimated cases. Treatment is provided through the DOTS strategy of supervised treatment and medication. The RNTCP has been implemented in phases to expand DOTS coverage across India and coordinate efforts with the National AIDS Control Organization to address TB-HIV coinfection.
This document provides an overview of respiratory system disorders for nursing students. It begins with the objectives and anatomy and physiology of the respiratory system. It then discusses various upper and lower respiratory tract disorders like pharyngitis, tonsillitis, adenoiditis, peritonsillar abscess, laryngitis and their associated nursing assessments, signs and symptoms, diagnoses and management. Surgical procedures like tonsillectomy are also outlined.
This document provides standard treatment guidelines for general hospitals in Ethiopia. It is published by the Drug Administration and Control Authority of Ethiopia and covers guidelines for infectious diseases, non-infectious diseases, pediatric diseases, and dermatological disorders. For each condition, it provides recommendations on diagnosis, treatment, and management. The guidelines are intended to help standardize care across hospitals in Ethiopia.
The document discusses tuberculosis (TB) control programs in Nepal. It notes that TB affects thousands in Nepal each year and is the sixth leading cause of death. The National TB Program aims to diagnose 70% of new cases and cure 85% by preventing 30,000 deaths in the next five years. The program registers over 30,000 TB cases annually and follows the WHO End TB Strategy and DOTS treatment model to control the disease.
The document discusses the evolution of tuberculosis (TB) control strategies in India over time. It begins with the epidemiology of TB and risk factors. The National Tuberculosis Programme was established in 1962 but had low treatment success rates. This led to the launch of the Revised National Tuberculosis Control Programme (RNTCP) in 1997, applying the WHO DOTS strategy. RNTCP expanded coverage and introduced strategies like DOTS-Plus for multi-drug resistant TB. More recent strategies include the STOP TB strategy (2006), Universal Access to TB Care (2010), and the National Strategic Plan (2012-2017) with a goal of TB elimination.
This document provides guidelines for programmatic management of tuberculosis preventive treatment in India. It discusses India's high burden of tuberculosis infection and the goal under the National Strategic Plan to provide treatment to 95% of eligible individuals by 2023. The document reviews evidence that tuberculosis preventive treatment reduces risk of developing active TB by 60-90% and is relatively safe. It recommends the 3-month rifampin and isoniazid regimen for individuals ages 0-15 based on evidence of efficacy, safety and improved adherence compared to longer regimens. The document also provides guidance on screening and treatment approaches for high-risk groups like people living with HIV and household contacts of active TB patients.
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.
This document outlines the Revised National Tuberculosis Control Programme (RNTCP) in India. It summarizes that tuberculosis poses a major public health burden in India, accounting for 1/3rd of global cases. The National Tuberculosis Control Programme started in 1962, but failed due to low treatment completion rates and organizational issues. RNTCP was launched in 1997 with DOTS strategy, which involves directly observed treatment, short-course. RNTCP aims to reduce morbidity, mortality, and transmission of TB in India through early case detection and standardized treatment. It utilizes a decentralized organizational structure and relies on community health workers to observe treatment. If fully implemented, RNTCP aims to achieve global targets for TB control by improving cure rates and case
This document discusses strategies for eliminating tuberculosis in India. It provides background on M. tuberculosis, describes how TB spreads from infected individuals, and outlines India's national tuberculosis control program and its commitment to end TB by 2025. It also summarizes diagnostic methods, treatment regimens, vulnerable populations, and the Pradhan Mantri TB Mukt Bharat Abhiyan initiative to engage communities in supporting individuals undergoing TB treatment.
This document provides a history of tuberculosis (TB) and efforts to control it. It discusses how TB was a major cause of death in Europe and America until antibiotics were developed in the mid-20th century. Major developments in treating and preventing TB are outlined, including the BCG vaccine and various antibiotic treatments. The document also summarizes global strategies to end TB, barriers to achieving targets, and the need for new tools and political/financial commitment to eliminate TB by 2030.
1.HIV Background and Epidemiology - Copy (2).pptssuser0c2aba
The global HIV epidemic affected 36.7 million people in 2017, including 5.1 million in Asia and the Pacific region. In Nepal, there were an estimated 31,020 people living with HIV in 2017. While HIV prevalence in the general adult population remains below 1%, the epidemic in Nepal is considered concentrated among key populations such as people who inject drugs, female sex workers, and men who have sex with men. The government of Nepal has set targets to identify 90% of estimated HIV cases, treat 90% of identified cases, and retain 90% of people on antiretroviral therapy by 2020 in order to end the AIDS epidemic in the country by 2030.
- India has the highest burden of tuberculosis (TB) in the world, accounting for over 20% of global TB cases.
- The National Strategic Plan for TB Control aims to achieve universal access to quality TB diagnosis and treatment through intensified case finding, improved diagnosis rates, and expanded access to treatment, including for drug-resistant TB and HIV/TB co-infection.
- New diagnostic technologies like molecular diagnostics, urine lipoarabinomannan tests, and breathalyzer tests have improved TB detection rates. The shorter daily drug regimen has also improved treatment outcomes.
- Initiatives to address TB among high-risk groups like people with diabetes, tobacco users, and in private healthcare settings have expanded
This document summarizes the current situation of leprosy in India and discusses future implications. It notes that while prevalence has decreased due to efforts like the National Leprosy Eradication Program, India still accounts for 60% of new global cases each year. The national strategy now focuses on active case detection campaigns in highly endemic areas, increasing awareness to reduce stigma, and exploring preventive approaches like chemoprophylaxis to break transmission chains and reach zero disease status. A single dose of rifampicin administered to contacts has shown up to 57% reduced risk of developing leprosy and is part of the current leprosy post-exposure prophylaxis program.
India has moved from a tuberculosis (TB) control program to eliminating TB through its National Strategic Plan for TB Elimination (2017-2025). Key challenges include engaging private providers, addressing drug-resistant TB, and preventing new TB cases. The plan aims to reduce TB incidence and mortality by 80% and 90% respectively by 2025. Strategies include engaging private providers, active case finding, addressing social determinants, and a multisectoral approach. The government's digital Nikshay program tracks TB cases and outcomes nationwide to support elimination goals.
Global tuberculosis rates have declined significantly since 1990. 56 million patients have been successfully treated and 22 million lives have been saved since 1995. The TB mortality rate has declined 45% globally since 1990. However, TB remains one of the top three killers of women worldwide. In 2012, there were an estimated 530,000 TB cases among children and 74,000 TB deaths among HIV-negative children. Treatment success rates have improved dramatically from 69% in 2000 to 87% in 2011. Despite progress, many TB cases are still being missed due to lack of diagnosis. In 2012, only 66% of the estimated 8.6 million incident TB cases were detected and notified. Multidrug-resistant TB also remains a major public health crisis,
Revised national tuberculosis control programmeRavi Rohilla
This document provides an overview of tuberculosis (TB) control in India. It discusses the background and epidemiology of TB globally and in India. It describes India's National TB Control Programme established in 1962 and the Revised National TB Control Programme (RNTCP) launched in 1997, which applies the WHO-recommended DOTS strategy. The RNTCP aims to achieve 85% treatment success among new sputum-positive TB patients and detect at least 70% of estimated cases. It emphasizes standardized treatment regimens, quality-assured diagnosis, and direct observation of treatment.
Epidemiology of tb with recent advances acknowledged by whoRama shankar
This document provides an overview of tuberculosis epidemiology and recent advances in tuberculosis programs. It discusses the global and national burden of tuberculosis, the evolution of tuberculosis control programs in India including the National Tuberculosis Control Programme and Revised National Tuberculosis Control Programme. It covers diagnosis, treatment, drug-resistant tuberculosis, tuberculosis and HIV coinfection, and recent advances acknowledged by the WHO. The post-2015 tuberculosis strategy in relation to sustainable development goals is also mentioned.
Fast-track the end of AIDS in the EU - practical evidence-based interventions.
Presentation by: Annette Verster, WHO
In a two-day meeting under the auspices of the Maltese Presidency of the Council of the European Union (30-31 January 2017), HIV experts from across the European Union discussed how to reverse this trend and how to prepare Europe to achieve the set target of ending AIDS by 2030.
1. Tuberculosis infection is highly prevalent in India, with an estimated 35-40 crore people infected, and 26 lakh estimated to develop TB disease annually. 2% of household contacts of active TB patients in a recent Indian study developed TB disease within 2 years.
2. Targeted testing for TB infection and provision of preventive treatment can significantly reduce the risk of developing active TB, by 60% on average and up to 90% for people living with HIV. Effective implementation of preventive treatment could reduce annual TB incidence in India by 8.3% based on modeling.
3. The National TB Elimination Program in India has issued guidelines for programmatic management of TB preventive treatment to help reduce
The document summarizes India's Revised National Tuberculosis Control Programme (RNTCP). It was established in 1992 by the government of India, WHO and World Bank in response to high TB mortality in India. The goal is to reduce mortality and interrupt transmission of TB. The strategy includes achieving at least 85% cure rates for infectious cases and detecting at least 70% of estimated cases. Treatment is provided through the DOTS strategy of supervised treatment and medication. The RNTCP has been implemented in phases to expand DOTS coverage across India and coordinate efforts with the National AIDS Control Organization to address TB-HIV coinfection.
This document provides an overview of respiratory system disorders for nursing students. It begins with the objectives and anatomy and physiology of the respiratory system. It then discusses various upper and lower respiratory tract disorders like pharyngitis, tonsillitis, adenoiditis, peritonsillar abscess, laryngitis and their associated nursing assessments, signs and symptoms, diagnoses and management. Surgical procedures like tonsillectomy are also outlined.
This document provides standard treatment guidelines for general hospitals in Ethiopia. It is published by the Drug Administration and Control Authority of Ethiopia and covers guidelines for infectious diseases, non-infectious diseases, pediatric diseases, and dermatological disorders. For each condition, it provides recommendations on diagnosis, treatment, and management. The guidelines are intended to help standardize care across hospitals in Ethiopia.
This document provides an overview of a curriculum on advanced nursing education and curriculum development. It discusses objectives of acquiring practical and theoretical knowledge, demonstrating teaching skills, developing lesson plans, and creating applicable curriculums. It also covers the purpose of nursing education in developing the nursing profession and delivering healthcare. Different types of discussion tasks are outlined, including guided, inquiry-based, reflective, and exploratory discussions. Criteria for effective learning through discussion include defining terms, identifying themes, allocating time, and applying material. References on student engagement techniques and the learning through discussion approach are also provided.
Acid base titration III [Compatibility Mode].pdfSani191640
I. Percentage content of Furosemide in the sample
= (Amount of furosemide found/Amount of furosemide claimed) x 100
Amount of furosemide found
= (Volume of NaOH used for sample - Volume of NaOH used for blank) x Normality of NaOH x Equivalent weight of furosemide
= (9.6 - 2) ml x 0.1 N x 33.07 mg/ml
= 319.92 mg
Amount of furosemide claimed
= Total furosemide in 20 tablets / Number of tablets
= 20 x 40 mg / 20 tablets
= 40 mg
Percentage content = (319
The document provides an overview of the neurological examination. It describes the key structures and functions of the nervous system. It then outlines the objectives and components of a complete neurological exam, including assessing mental status, cranial nerves, motor function, coordination, and gait. The document provides detailed instructions on techniques for testing each cranial nerve and evaluating muscle tone, strength, and coordination.
This document defines pediatric seizures and epilepsy, describes the different types of seizures including partial, generalized, absence, myoclonic, atonic, and tonic-clonic seizures. It discusses the epidemiology, pathophysiology, classification, and etiologies of seizures in children. Seizures are common in children, especially those under 3 years old, and have different characteristics compared to seizures in adults due to the immature nervous system in children. Febrile seizures occur in 3% of children. Genetic factors account for 20% of childhood epilepsy cases.
This document summarizes chronic complications of diabetes mellitus, including macrovascular complications like coronary heart disease, stroke, and peripheral arterial disease, as well as microvascular complications like diabetic neuropathy, retinopathy, and nephropathy. It provides details on the pathogenesis, clinical presentation, diagnosis and management of peripheral diabetic neuropathy, noting that tight glycemic control through intensive insulin therapy can help prevent or delay the risk of developing diabetic complications.
Anemias are diseases characterized by decreased hemoglobin and red blood cells, resulting in reduced oxygen-carrying capacity of blood. Anemias can be classified based on red blood cell morphology, etiology, or pathophysiology. Treatment depends on the underlying cause but may involve oral or parenteral iron for iron deficiency, oral vitamin B12 and folic acid for deficiencies of those vitamins, and addressing the underlying chronic disease for anemia of chronic disease. The goals of treatment are to alleviate symptoms, correct the underlying cause, and prevent recurrence of anemia.
A 6-year-old female child presented with general body swelling, fever, loss of appetite, and dermatitis around the lower extremities for one month. She was diagnosed with severe acute malnutrition (SAM) with kwashiorkor. Her treatment plan included nutritional therapy with F-75 and F-100, antibiotics including amoxicillin, ampicillin, gentamicin, and cloxacillin to treat potential infections, and vitamin A supplementation. Her drug therapy was changed from amoxicillin to cloxacillin due to ineffective treatment with amoxicillin. Her condition improved with the treatment plan.
This document provides an introduction to medical and surgical nursing. It discusses key topics like the differences between medical and surgical nursing, Maslow's hierarchy of needs, stress responses, and stages of the stress response. The roles of nurses in medical-surgical settings are outlined. Concepts like health, illness, disease, and wellness are defined. Factors that influence psychological responses to illness like crisis and coping are also explained.
Atherosclerosis develops as a chronic inflammatory response to endothelial injury. Lesions progress through interactions between modified lipoproteins, immune cells, and arterial wall cells. Atherosclerosis is characterized by atheromatous plaques that protrude into and obstruct arteries. Major complications include myocardial infarction, stroke, aneurysms, and peripheral vascular disease. Coronary artery disease occurs when plaques accumulate in the coronary arteries, restricting blood flow and oxygen supply to heart muscle. Left untreated, coronary artery disease can progress to myocardial infarction.
Unit II. Respiratory system disorders.pptxSani191640
This document provides information on disorders of the respiratory system. It begins by describing the anatomy and functions of the respiratory system, including the conducting airways. It then discusses various upper and lower respiratory tract disorders like tonsillitis, pharyngitis, laryngitis, sinusitis, acute tracheo-bronchitis, and chronic bronchitis. For each disorder, it provides information on definition, causes, signs and symptoms, management, and nursing interventions. The document concludes with describing assessment techniques for respiratory disorders.
This document provides an overview of musculoskeletal disorders, including soft tissue injuries like sprains and strains, their signs and symptoms, and general management using RICE (rest, ice, compression, and elevation). Joint disorders like dislocations, osteoarthritis, and rheumatoid arthritis are also discussed. Osteomyelitis, a bone infection, is described in terms of causes, symptoms, diagnosis, and nursing interventions. The document aims to educate nurses on caring for patients with various musculoskeletal conditions.
This document discusses antidiabetic drugs used to treat diabetes mellitus. It describes the two main types of diabetes and then focuses on insulin and oral hypoglycemic agents. Insulin is described in detail including its mechanism of action, types, administration, and potential complications. Oral hypoglycemic agents discussed include sulfonylureas, which stimulate insulin release, and biguanides like metformin, which lower hepatic glucose production and increase insulin sensitivity. The document provides information on the mechanisms, pharmacokinetics, uses, and adverse effects of these important antidiabetic medications.
This document discusses pediatric nutrition and malnutrition. It begins by outlining the changing nutritional needs of children based on their age and development. It then discusses the global burden of child malnutrition. The document covers nutritional recommendations for infants from birth to 1 year old, including the benefits of breastfeeding. It also discusses protein-energy malnutrition, providing classifications and clinical manifestations such as marasmus and kwashiorkor. The principles of management are outlined, including resolving life-threatening conditions, restoring nutritional status through feeding phases, and ensuring rehabilitation.
The pelvis is composed of four bones - the two innominate bones, the sacrum, and the coccyx. The innominate bones are each made up of three parts: the ilium, ischium, and pubis. The sacrum is wedge-shaped with five fused vertebrae. The coccyx consists of four fused vertebrae at the base of the sacrum. There are four pelvic joints that connect the bones: the symphysis pubis, two sacroiliac joints, and the sacrococcygeal joint. The pelvis is divided into the false pelvis and true pelvis, with the true pelvis further divided into the brim,
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Here are some key objectives of communication with children:
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Hypertension, also known as high blood pressure, is a serious medical condition that occurs when blood pressure in the body's arteries is consistently too high. Blood pressure is the force of blood pushing against the walls of blood vessels as the heart pumps it. Hypertension can increase the risk of heart disease, brain disease, kidney disease, and premature death.
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2. कार्य अबको , क्षर्रोग अन्त्यको
It’s time for action! It’s time to End TB
3. Vision: TB Free Nepal
Goal:
To reduce the mortality, morbidity and transmission of tuberculosis until it is no
longer a public health problem and ultimately to eliminate TB.
Objective:
- To reduce the incidence of TB by 20% by 2021 and 90% by 2035
- To reduce the TB deaths by 35% by 2020 and 95% by 2035
- To reduce the catastrophic cost to families due to TB to 0% by 2035
With Regards to SDG, target are:
Vision, Goal and Objectives of NTP
2015 2019 2022 2025 2030
SDG targets: 3.3.2
Tuberculosis
incidence (per
100,000 population)
158 85 67 55 20
4.
5. 14%
21%
24%
7%
20%
4%
10%
Distribution of TB cases by
Province (%)
Province-1
Province-2
Bagmati
Province
Gandaki
Province
Province-5
Karnali
Province
Sudurpaschi
m Province
3%
25%
59%
13%
TB case Notification by
ecological belt (%)
Mountain Hill
Terai Kathmandu Valley
7. 34112
32056
31764
32474
32043
123
112
111
112 109
50
100
150
200
250
300
30500
31000
31500
32000
32500
33000
33500
34000
34500
2071/72 2072/73 2073/74 2074/75 2075/76
CNR
per
100,000
Total
TB
case
notified
(In
Number)
Axis Title
Trend of TB case Notification and CNR
Notified TB Cases CNR
Case Notification in Rates and Numbers (National)
Annual Trend
• Globally, an estimated 10.0 million people fell ill with TB in 2075/76.
• Nepal population contributed to 0.35% of the global population, but with regards to TB,
Nepal accounted for 0.5% of global TB cases.
• Among 32043 reported case, 82% of pulmonary cases were bacteriologically confirmed
10. 30% 20% 10% 0% 10% 20% 30%
65+
55-64
45-54
35-44
25-34
15-24
5-14
0-4
Age
group
Distribution of TB cases (in percent)
by Age and Sex
% Of Female % Of Male
64%
36%
Distribution of notified TB cases by Age and Sex
(FY 2075/76)
• Most cases were reported in the middle age group with the highest of 48 % in 15-44 years of age
hints towards age shifting to higher age meaning a healthier younger population and improving TB
program
• Men were 1.77 times more than women among the reported TB case. (aligns to Global estimates)
11. Five years trend on type of TB
• Bacteriological confirmation improving than previous year Nearly 78% of those
bacteriological testing are through rapid DST (Xpert MTB/RIF testing), better than previous
year testing of only 57%)
12. TB HIV testing and enrollment in treatment
Improved HIV testing among TB cases :
• Among all TB cases, 0.7% were people living with HIV (PLHIV), which was lower than the
global context as Nepal is a low HIV prevalent country.
• The percentage of notified TB patients who had a documented HIV test result in 2075/76
was 69%, up from 67% in previous year.
13. 91
91 91 91
91
90
90
90 90
90
88.5
89
89.5
90
90.5
91
91.5
92
FY 71/72
(14/15)
FY 72/73
(15/16)
FY 73/74
(16/17)
FY 74/75
(17/18)
FY 75/76
(18/19)
TSR
in
%
Treatment Success Rate (Annual Trend)
Success Rate (All forms) PBC (New+Relapse) Success Rate
Treatment Success Rate (%)
48%
43%
1%
3%
3%
2%
National Treatment Outcome (in %)
Cured Completed Failure
Died Lost to Follow-up Not Evaluated
Sustained High treatment success rates in Nepal
Among reported, 32313 TB cases were successfully treated (TSR >90%) better than global
commitment of 85% or more.
14. DR Case notification, treatment coverage and outcome
• 392 reported cases of RR MDR; 0.6% new TB cases and
20% previously treated case (compared to 3.4% of new
TB and 18% of previously treated cases globally)
possible under detection in Nepal
• Some progress in testing, detection, and treatment of
MDR/RR-TB
• TB were tested for rifampicin resistance, up from
57% in 2074/75 to 78% in 205/76.
• The coverage of testing was 79% for new and
74% for previously treated TB patients.
• 71% were successfully treated (compared to
global TSR of 56 %).
• 5% of MDR TB were treated with the new shorter
regimen with 65% success rates.
• Key Challenge nearly 38% are lost to follow up.
15. TB Preventives
Services
NTP recommends TB
preventive treatment for:
• PLHIV
• household contacts under
5 years of bacteriologically
confirmed pulmonary TB
cases.
A total of 2026 PLHIV were
started on TB preventive
treatment in 2075/76, based
on data from NCASC.
TBPT for children under five
years who are the contacts of
TB cases increased by 4-fold
compared to FY 74/75 to
2,397.health
BCG vaccination is being
provided as part of national
childhood immunization
programmes. The coverage of
BCG vaccine was 92% in FY
74/75.2075/76, 2 397 children and 2
026 PLHIV received the TB preventive
therapy which has improved since
2074/75. BCG vaccine can also confer
protection, but mostly from severe
forms of TB in children. BCG coverage in
Nepal was more than 90%.
16. Key facts regarding Facilities
Treatment Facilities
Facilities Current
DOT Centers 4382
Urban DOT 96
MDR Treatment
Centers
21
MDR Treatment
Sub Centers
86
DR Home 1
Laboratory facilities
Facilities No. Services
Microscopy
Centers
604 Microscopy Centers
GeneXpert
facility
56 Uses sputum sample, Result in
2 hour
Culture labs
and DST
2 Duration of test is 2 month
Line Probe
Assay(LPA)
2 Confirmation of DR TB from
sputum positive samples, in 2
days
17. National TB Prevalence
Survey, 2018-19
Key findings
• The first ever nationally
representative TB survey to
understand the actual TB disease
burden in the general population
in Nepal.
• Also measured the health-care
seeking behaviour and service
utilization among survey
participants.
• 99 Cluster , 55 districts,
around 500-600 population
per cluster, total of 57 589
sample size.
18. Burden estimates – based
on results of Prevalence
survey
• According to the survey, TB
burden is much higher than
previously estimated
• currently over 117 000
people are living with TB
disease in Nepal.
• Likewise, 69 000 people
developed TB in 2018.
• TB burden is 1.6 times higher
than previously estimated
Annually missing cases nearly
54%
• Most diagnosed by use of X-
ray (more 70%) , and use of
Xpert
• Prevalence higher among
Men, higher in elderly (≥65
years) and in all terrains (not
only in Terai and KTM which
reported highest no. of cases
to NTP)
• Burden still high , but
Successful TB program – 3 %
annual decline estimated
since last decade.
19. • Current practice of TB symptom screening using single question of cough
more than 2 weeks can miss cases. 5.8% TB cases had cough <2 weeks but
additional other symptoms.
• Chest x-ray found to be a better screening tool for TB: More than 70% of the
confirmed TB cases had no symptom but only X-ray suggestive of TB.
• GeneXpert (molecular technology for the diagnosis of TB) detected more TB
cases as compared to smear microscopy, making it more reliable and efficient
test.
• DOTS, essential for sustaining high TB treatment success rate: Survey finding
shows more than 80% of participants had been adhering to treatment as a
result of direct supervision. Hence, DOTS need to be scaled up community
level to sustain the current excellent (91%) treatment success rate.
• High trust on Govt. health facilities: Patients had high trust in the
government health facilities; it provides opportunity to strengthen quality of
care in the government health facilities complemented by private sector.
• TB and migration: Significant number of people seek TB services across the
country.
National TB Prevalence Survey, 2018-19
Key findings
20. NTP achievements
o Domestic resources have been increased in the program 27% in 2013/14 and 55%
in 2017/18.
o 3% decline of incidence per year, but gap still high.
o Treatment success rate for DSTB above 90% and DRTB- nearly 70%.
o Successfully completion of National TB prevalence survey in Nepal
o Expansion of sensitive molecular diagnostic tools (Genexpert) in the country
from 22 Xpert centers in 2014 and 63 centers currently.
o DRTB patients are covered under health insurance (no premium needed).
o Tertiary hospital for TB program under construction.
o Initiated a shorter treatment regimen (9 months) for DRTB patients all over the
country from 2017 and transition into all oral longer regimen as recommended by
WHO.
21. Way Forward
Ensure high-level political commitment to END TB.
• Essential to mobilize other sectors beyond health such as industries, education,
finance, private sectors, communities to engage in TB care and support.
• Sustain the TB and MDR-TB response through high-level political commitment,
strong leadership across multiple government sectors, partnerships and adequate
investments in TB, including cross border collaboration.
Improve access to quality TB service.
• Ensure better access to more sensitive screening and diagnostic tools such as
(chest X-ray and Xpert MTB/RIF. LPA, LAMP etc) to ensure early detection of TB.
• Better and tertiary treatment services (complete central TB hospital -2020)
• Ensure quality and patient friendly treatment services both at health facilities and
in communities (e.g. Community Based DOT, family-based DOT etc).
22. Way Forward
Engage private sector in provision of high-quality TB services
• Improve roles of the private sector and hospitals in TB control to deliver high quality
TB care and services.
• Implement mandatory case notification
Increase awareness and create demand for quality TB services
• Empower communities with proper knowledge of TB and generate demand for
quality TB services.
• Provide patients and their families with appropriate supports including social support
and contact tracing.
Ensure increased investment in TB, both financial and human resources, to meet the Global
commitment to #ENDTB#
• Commit to increase domestic investment for TB.
Domestic resource increased from 27% in 2014/15 to 55% in 2017/18, but still
hugely underbudgeted.
Ensure around 15 billion NPR for next 2021-25 NSP if end TB is to be reached as
committed.
• Advocate for increased donor investment for TB.
• Ensure adequate human resources at all levels.
• Ensure NO out of pocket expenditure by TB affected families.
23.
24. TB is a Global Issue
with
Global impact and
only by working together we can eliminate it.