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    RNTCP

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    The Revised National Tuberculosis Control Programme (RNTCP) was implemented in India to address shortcomings of the previous National Tuberculosis Programme (NTP). Key changes included improved diagnostics using sputum smear microscopy, standardized treatment regimens directly observed by health workers, and expanding coverage across India. The RNTCP was implemented in phases from 1993 to 2006 and achieved high treatment success rates and reduced mortality. It utilizes a laboratory network and engages public and private providers to work toward eliminating TB in India.

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    RNTCP

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    arunjv1234
    4K views24 pages
    The Revised National Tuberculosis Control Programme (RNTCP) was implemented in India to address shortcomings of the previous National Tuberculosis Programme (NTP). Key changes included improved diagnostics using sputum smear microscopy, standardized treatment regimens directly observed by health workers, and expanding coverage across India. The RNTCP was implemented in phases from 1993 to 2006 and achieved high treatment success rates and reduced mortality. It utilizes a laboratory network and engages public and private providers to work toward eliminating TB in India.

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    TUBERCULOSIS CONTROL PROGRAMME IN INDIA

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    The Revised National Tuberculosis Control Programme (RNTCP) was implemented in India to address shortcomings of the previous National Tuberculosis Programme (NTP). Key changes included improved diagnostics using sputum smear microscopy, standardized treatment regimens directly observed by health workers, and expanding coverage across India. The RNTCP was implemented in phases from 1993 to 2006 and achieved high treatment success rates and reduced mortality. It utilizes a laboratory network and engages public and private providers to work toward eliminating TB in India.

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    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    4K views24 pages

    RNTCP

    Uploaded by

    arunjv1234
    The Revised National Tuberculosis Control Programme (RNTCP) was implemented in India to address shortcomings of the previous National Tuberculosis Programme (NTP). Key changes included improved diagnostics using sputum smear microscopy, standardized treatment regimens directly observed by health workers, and expanding coverage across India. The RNTCP was implemented in phases from 1993 to 2006 and achieved high treatment success rates and reduced mortality. It utilizes a laboratory network and engages public and private providers to work toward eliminating TB in India.

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    of 24

    REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP)

    1/26/2014

    RNTCP

    MILE STONES OF RNTCP


    1962-NTP (NATIONAL TUBERCULOSIS

    PROGRAMME) 1992-GOI,WB,WHO REVIEWED NTP 1993-RNTCP PILOT PROJECT STARTED 1998-LARGE SCALE IMPLEMENTATION OF RNTCP 2006-WHOLE COUNTRY COVERED BY RNTCP

    1/26/2014

    RNTCP

    NTP (1962)
    OBJECTIVES: To identify and treat as large a number of TB patients as possible so that infectious cases are rendered noninfectious. To reduce the magnitude of TB problem in the country to a level where it ceases to be a public health problem. PROGRAM ACTIVITIES WERE: Case detection Case treatment Health education BCG vaccination
    1/26/2014 RNTCP 3

    NEED FOR REVISED STRATEGY


    OVER EMPHASIS ON X-RAYS FOR DIAGNOSIS INADEQUATE FUNDING,POOR QUALITY MICROSCOPY NON-STANDARD TREATMENT REGIMENS LOW RATES OF TREATMENT COMPLETION LACK OF SYSTEMATIC INFORMATION ON TREATMENT

    OUTCOME ONLY 30% OF ESTIMATED TB PATIENTS WERE DIAGONOSED ONLY 30% OF THE DIAGONOSED CASES WERE TREATED SUCCESSFULLY
    1/26/2014 RNTCP 4

    Objectives of RNTCP
    To achieve and maintain a cure rate of at least 85% among

    newly detected infectious (new sputum smear positive) cases


    To achieve and maintain detection of at least 70% of such

    cases in the population

    1/26/2014

    RNTCP

    Organization and administration


    Central level
    Tuberculosis Division in the Directorate General

    Health services

    National Tuberculosis Institute, Bangalore and

    Tuberculosis Research centre at Chennai

    1/26/2014

    RNTCP

    Health Minister

    Health Secretary MD NRHM Director Health Services

    Additional / Deputy / Joint Director (State TB Officer)

    State Training and Demonstration Center (TB) Director, IRL Microbiologist, MO, Epidemiologist/statistician, IRL LTs etc.,

    State TB Cell Deputy STO, MO, Accountant, IEC Officer, SA, DEO, TB HIV Coordinator etc.,

    1/26/2014

    IRL-INTERMEDIATE REFERNCE LABORATORY

    Structure of RNTCP at district levels


    District Administration
    District Magistrate/ District Collector

    District Health Services

    Chief Medical Officer and other supporting staff

    Nodal point for TB control

    District TB Centre
    DTO, MO-DTC

    One/ 500,000 (250,000 in hilly/ difficult/ tribal area)

    Tuberculosis Unit

    Medical officer-TB Control, Senior Treatment supervisor(STS), Senior TB Laboratory Supervisor(STLS)

    One/ 100,000
    (50,000 in hilly/ difficult/ tribal area)

    Microscopy Centre

    Medical Officer, paramedical staff And Laboratory Technician


    TB Health Visitors (TBHV), DOT Provider (MPW, NGO, ASHA, Community Volunteers)

    DOT Centre
    1/26/2014 RNTCP

    LABORATORY NETWORK UNDER RNTCP


    1/26/2014 RNTCP 9

    1/26/2014

    RNTCP

    10

    Diagnosis of TB in RNTCP: Smear examination


    Cough for 3 weeks or More

    3 sputum smears
    3 or 2 positives 1 positive smear

    3 Negative Antibiotics 1-2 weeks Symptoms persist X-ray Negative For TB

    X- ray
    positive Smear-Positive TB negative

    Positive Smear-Negative TB Anti-TB Treatment

    Anti-TB Treatment Non-TB

    DOTS DIRECTLY OBSERVED TREATMENT SHORT COURSE

    1/26/2014

    RNTCP

    12

    Components of DOTS

    Political and administrative commitment

    Good quality diagnosis, primarily by sputum smear microscopy

    Uninterrupted supply of good quality drugs

    Directly observed treatment (DOT)

    accountabilitY

    The emergence of resistance to drugs used to treat TB, and particularly multi-drug-resistant TB (MDR TB), has become a significant public health problem and an obstacle to effective TB control.

    Atleast resistant to INH & Rifampicin with or without resistance to other TB drugs

    14

    XDR TB
    XDR TB = MDR TB+ Resistant to Second line injectable Anti TB drug & Fluroquinolone Second line drugs-ethionamide,capreomycin,kanamycin etc

    15

    DOTS Plus
    DOTS Plus refers to a DOTS program that adds components for MDR TB diagnosis, management, and treatment. For diagnosing MDR TB cases RNTCP has introduced state level quality assured laboratories with facilities for sputum culture.

    16

    TB and HIV co-ordination


    Key areas of focus : Sensitization of key policy makers to address importance of TB-HIV coordination. Co-ordination of service delivery and cross referrals Joint training programmes VCTC RNTCP coordination Use of universal precautions to prevent TB in HIV treatment facilities and prevent spread of HIV through safe injection practices in RNTCP. Joint IEC campaigns and evaluation systems Active involvement of NGOs,private practitioners and corporate sector.
    17

    Pediatric tuberculosis
    Drugs for pediatric TB patients are also supplied
    on patient wise boxes (PWBs) Treatment based on childs body weight 2 generic pediatric PWBs 6 -10 kg weight band 11-17 kg weight band

    Global first for RNTCP as no other DOTS programme has PWBs for children.

    18

    RNTCP PHASES
    RNTCP PHASE I 1997-2006 RNTCP PHASE II 2006-2011 RNTCP PHASE III 2012-2017

    RNTCP in Phase I (1997-2006)was to ensure high quality DOTS expansion in the country

    19

    RNTCP PHASE II 2006-2011


    Pursue quality DOTS expansion and enhancement Address TB-HIV, MDR-TB and other challenges, Contribute to health system strengthening, Involve all health care providers, Engage people with TB, and affected communities Enable and promote research

    20

    Programme activities necessary to achieve RNTCP III(2012-2017) targets

    Strengthening and improving the quality of basic DOTS services Further strengthen and align with the health system under National Rural Health Mission (NRHM) Deploying improved rapid TB diagnostics to the field level Strengthen urban TB control Expand diagnosis and treatment of drug-resistant TB Improve communication and outreach and social mobilization Promote research for development and implementation of improved tools and strategies
    21

    ACHIEVEMENTS OF RNTCP
    COVERS WHOLE COUNTRY BY 2006

    TREATMENT SUCCESS RATE INCREASED FROM 25% TO 87 %


    DEATH RATE REDUCED FROM 29% TO 4%

    INVOLVEMENT OF NGOS,PRIVATE PRACTITIONERS ALONG


    WITH GENERAL HEALTH CARE SYSTEM

    TRAINING OF MORE THAN 5 LAKH HEALTH WORKERS MORE THAN 12,000 DMCS ESTABLISHED THROUGHOUT THE
    COUNTRY
    22

    STOP TB STRATEGY BY WHO


    FROM 2006-2015 (10 YEARS) DOTS IS THE CORE OF THIS STRATEGY

    23

    24

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