Tuberculosis in india

Sahdev Bishnoi
Sahdev BishnoiSahdev Bishnoi
T.B.
(TUBERCULOSIS)
BURDEN IN
INDIA
Presented By:- Sahdev
Definition
 Tuberculosis(TB) is a potentially fatal contagious disease
that can affect almost any part of the body but is an mainly
infection of the lungs. It is caused by mycobacterium
tuberculosis.
 Tubercule – Round nodule/swelling
Osis – condition
 Tuberculosis (TB) control activities are implemented in the
country for more than 50 years. The National TB
Programme (NTP) was launched by the Government of
India in 1962 in the form of District TB Centre model
involved with BCG vaccination and TB treatment. In 1978,
BCG vaccination was shifted under the Expanded
Programme on Immunization.
Lung Tuberculosis
Pulmonary T.B.
Extrapulmonary T.B.
Sign & Symptoms
Epidemiology
Continue…
Worldwide TB Patients
TB Burden Countries
TB Burden in India
Continue…
Continue…
Continue…
MDR & TB Cases
Diagnosis Process T.B.
Diagnosis
Positive Skin Test
Continue…
Lab Tests
Continue…
T.B. Program in India
Evolution of TB Program
RNTCP Program
Goal & Objectives
Continue…
Continue…
Features
DOTS
Around the same time in1993, the WHO declared
TB as a global emergency, devised the directly
observed treatment – short course (DOTS), and
recommended to follow it by all countries. The
Government of India revitalized NTP as Revised
National TB Control Programme (RNTCP) in the
same year. DOTS was officially launched as the
RNTCP strategy in 1997 and by the end of 2005
the entire country was covered under the
programme.
Nikshay
NIKSHAY:- To facilitate TB notification, RNTCP
has developed a case-based web-based TB
surveillance system called “NIKSHAY”
(https://nikshay.gov.in ) for both government
and private health care facilities. Future
enhancements under NIKSHAY are for patients
support, logistics management, direct data
transfers, adherence support and to support
interface agencies which are supporting
programme to expand the reach.
Nikshay Poshak Yojna
It is centrally sponsored scheme under
National Health Mission (NHM), financial
incentive of Rs.500/- per month is provided
for nutritional support to each notified TB
patient for duration for which the patient is on
anti-TB treatment. Incentives are delivered
through Direct benefit transfer (DBT) scheme
to bank accounts of beneficiary*.
Second Phase 2006-11
During 2006–11, in its second phase RNTCP improved
the quality and reach of services, and worked to reach
global case detection and cure targets. TB was the
leading cause of illness and death among persons living
with HIV/AIDS and large number of multidrug resistant
TB (MDR-TB) cases were reported every year. During
this period for achievement of the long term vision of a
“TB free India”, National Strategic Plan for Tuberculosis
Control 2012-2017 was documented with the goal of
‘universal access to quality TB diagnosis and treatment
for all TB patients in the community’.
Plan for 2012-2017
Significant interventions and initiatives were
taken during NSP 2012-2017 in terms of
mandatory notification of all TB cases, integration
of the programme with the general health
services (National Health Mission), expansion of
diagnostics services, programmatic management
of drug resistant TB (PMDT) service expansion,
single window service for TB-HIV cases, national
drug resistance surveillance and revision of
partnership guidelines.
National strategic plan for tuberculosis
elimination 2017-2025
• RNTCP has released a ‘National strategic plan
for tuberculosis 2017-2025’ (NSP) for the
control and elimination of TB in India by 2025.
According to the NSP TB elimination have
been integrated into the four strategic pillars
of “Detect – Treat – Prevent – Build” (DTPB).
PPP
 Public private partnership:- For promotion of public-private mix
(PPM) in TB prevention and care, private providers are provided
incentives for TB case notification, and for ensuring treatment
adherence and treatment completion. The incentives are provided
through direct beneficiary transfer.
 The incentives to the Private Sector TB Care Provider are as
follows:
 Rs 250/- on notification of a TB case diagnosed as per Standards for
TB Care in India (STCI).
 Rs 250/- on completion of every month of treatment.
 Rs 500/- on completion of entire course of TB treatment.
 Rs 2750/ for notification and management of a drug-sensitive
patient over 6-9 months as per STCI.
 Rs 6750/-for notification and correct management of a drug-
resistant case over 24 months as per STCI.
Free drugs and diagnostic tests to TB
patients in private sector
• Free drugs and diagnostic tests are provided
to TB patients seeking treatment from private
health sector. There are two approaches for
ensuring access to free drugs and diagnostic
tests to TB patients in private sector, first is
access to programme- provided drugs and
diagnostics through attractive linkages; and
second is reimbursement of market- available
drugs and diagnostics.
TB Elimination by 2025
• However, to eliminate TB in India by 2025, five
years ahead of the global target, a framework to
guide the activities of all stakeholders including
the national and state governments,
development partners, civil society organizations,
international agencies, research institutions,
private sector, and many others whose work is
relevant to TB elimination in India is formulated
by RNTCP as National Strategic Plan for
Tuberculosis Elimination 2017-2025.
Continue…
Continue…
Continue…
Prevention
Air borne infection control measures
Contact tracing
Isoniazid Preventive Therapy (IPT)
BCG vaccination
Addressing social determinants of TB like poverty,
malnutrition, urbanization, indoor air pollution, etc.
Build:- the form of building and strengthening enabling
policies, empowering institutions and human resources
with enhanced capacities.
BCC & IEC
T.B. Division in India
Work Flow Analysis
Organisation Structure of RNTCP
Structure of RNTCP
RNTCP Laboratory Network
State Level RNTCP
State Structure of RNTCP
RNTCP District Level
Urban TB Control
MDTCS
Bibliography
https://www.nhp.gov.in/revised-national-
tuberculosis-control-programme.
https://tbcindia.gov.in/showfile.php?lid=3322
https://tbcindia.gov.in/WriteReadData/NSP%2
0Draft%2020.02.2017%201.pdf.
Tuberculosis in india
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Tuberculosis in india

  • 2. Definition  Tuberculosis(TB) is a potentially fatal contagious disease that can affect almost any part of the body but is an mainly infection of the lungs. It is caused by mycobacterium tuberculosis.  Tubercule – Round nodule/swelling Osis – condition  Tuberculosis (TB) control activities are implemented in the country for more than 50 years. The National TB Programme (NTP) was launched by the Government of India in 1962 in the form of District TB Centre model involved with BCG vaccination and TB treatment. In 1978, BCG vaccination was shifted under the Expanded Programme on Immunization.
  • 11. TB Burden in India
  • 15. MDR & TB Cases
  • 23. Evolution of TB Program
  • 29. DOTS Around the same time in1993, the WHO declared TB as a global emergency, devised the directly observed treatment – short course (DOTS), and recommended to follow it by all countries. The Government of India revitalized NTP as Revised National TB Control Programme (RNTCP) in the same year. DOTS was officially launched as the RNTCP strategy in 1997 and by the end of 2005 the entire country was covered under the programme.
  • 30. Nikshay NIKSHAY:- To facilitate TB notification, RNTCP has developed a case-based web-based TB surveillance system called “NIKSHAY” (https://nikshay.gov.in ) for both government and private health care facilities. Future enhancements under NIKSHAY are for patients support, logistics management, direct data transfers, adherence support and to support interface agencies which are supporting programme to expand the reach.
  • 31. Nikshay Poshak Yojna It is centrally sponsored scheme under National Health Mission (NHM), financial incentive of Rs.500/- per month is provided for nutritional support to each notified TB patient for duration for which the patient is on anti-TB treatment. Incentives are delivered through Direct benefit transfer (DBT) scheme to bank accounts of beneficiary*.
  • 32. Second Phase 2006-11 During 2006–11, in its second phase RNTCP improved the quality and reach of services, and worked to reach global case detection and cure targets. TB was the leading cause of illness and death among persons living with HIV/AIDS and large number of multidrug resistant TB (MDR-TB) cases were reported every year. During this period for achievement of the long term vision of a “TB free India”, National Strategic Plan for Tuberculosis Control 2012-2017 was documented with the goal of ‘universal access to quality TB diagnosis and treatment for all TB patients in the community’.
  • 33. Plan for 2012-2017 Significant interventions and initiatives were taken during NSP 2012-2017 in terms of mandatory notification of all TB cases, integration of the programme with the general health services (National Health Mission), expansion of diagnostics services, programmatic management of drug resistant TB (PMDT) service expansion, single window service for TB-HIV cases, national drug resistance surveillance and revision of partnership guidelines.
  • 34. National strategic plan for tuberculosis elimination 2017-2025 • RNTCP has released a ‘National strategic plan for tuberculosis 2017-2025’ (NSP) for the control and elimination of TB in India by 2025. According to the NSP TB elimination have been integrated into the four strategic pillars of “Detect – Treat – Prevent – Build” (DTPB).
  • 35. PPP  Public private partnership:- For promotion of public-private mix (PPM) in TB prevention and care, private providers are provided incentives for TB case notification, and for ensuring treatment adherence and treatment completion. The incentives are provided through direct beneficiary transfer.  The incentives to the Private Sector TB Care Provider are as follows:  Rs 250/- on notification of a TB case diagnosed as per Standards for TB Care in India (STCI).  Rs 250/- on completion of every month of treatment.  Rs 500/- on completion of entire course of TB treatment.  Rs 2750/ for notification and management of a drug-sensitive patient over 6-9 months as per STCI.  Rs 6750/-for notification and correct management of a drug- resistant case over 24 months as per STCI.
  • 36. Free drugs and diagnostic tests to TB patients in private sector • Free drugs and diagnostic tests are provided to TB patients seeking treatment from private health sector. There are two approaches for ensuring access to free drugs and diagnostic tests to TB patients in private sector, first is access to programme- provided drugs and diagnostics through attractive linkages; and second is reimbursement of market- available drugs and diagnostics.
  • 37. TB Elimination by 2025 • However, to eliminate TB in India by 2025, five years ahead of the global target, a framework to guide the activities of all stakeholders including the national and state governments, development partners, civil society organizations, international agencies, research institutions, private sector, and many others whose work is relevant to TB elimination in India is formulated by RNTCP as National Strategic Plan for Tuberculosis Elimination 2017-2025.
  • 40. Prevention Air borne infection control measures Contact tracing Isoniazid Preventive Therapy (IPT) BCG vaccination Addressing social determinants of TB like poverty, malnutrition, urbanization, indoor air pollution, etc. Build:- the form of building and strengthening enabling policies, empowering institutions and human resources with enhanced capacities. BCC & IEC
  • 50. MDTCS