RNTCP Annual Report 2012 - TBC India

2 categories (New and Previously treated cases) based
on the recommendations of experts and endorsement
by National Task Force for Medical colleges.
Comprehensive training materials have been developed
for all categories of staff. The training materials are
modular in content and a number of them have been
recently revised keeping in view the new developments
in RNTCP. Modular trainings ensures uniform standard
and avoids possible subjectivity and bias in trainings.
To improve access to tribal and other marginalized
groups the programme has developed a Tribal action
plan which is being implemented with the provision of
additional TB Units and DMCs in tribal/difficult areas,
provision of TBHVs (peripheral health worker) for urban
areas, compensation for transportation of patient &
attendant in tribal areas, higher rate of salary to contractual
staff posted in tribal areas and enhanced vehicle
maintenance and travel allowance in tribal areas Studies
to document utilization by marginalized groups
Drug Resistance Surveillance (DRS) of Gujarat,
Maharashtra and Andhra Pradesh, estimated the
prevalence of Multidrug Resistant TB (MDR-TB) to be
about 2-3% in new cases and 12-17% in retreatment cases.
These surveys also indicate that the prevalence of MDR-
TB is not increasing in the country.
The programme is in the process of establishing a network
of accredited Culture and Drug Susceptibility Testing
(DST) Intermediate Reference Laboratories (IRLs) across
the country in a phased manner for diagnosis and follow
up of MDR TB patients. Currently 38 labs are accredited
and are functioning across the country.
The RNTCP has initiated evaluation of the Gene-Xpert
TB-RIF in line with the global consultation guidelines to
gather evidence for use within the country in various
settings including non-risk settings.
LAMP (Loop mediated isothermal amplification) is a
manual NAAT that can be performed at microscopy
level is currently undergoing validation by FIND in IGMS
Wardha.
Multi Drug resistant TB (MDR TB): MDR-TB
services have been initiated in all states in the country. All
35 States/UTs have introduced PMDT services in some
districts with variable access and scaling up. 508 million
(43%) population have access to services that varies from
states to state as depicted in the figure below. 38287 MDR
TB suspects have been examined till the end of 2011,
10267 MDR-TB patients have been diagnosed and 6994
have been put on treatment.
Executive Summary
TB/HIV: The "National framework of Joint TB/HIV
Collaborative activities" was revised in 2009 which
establishes uniform activities at ART centres and ICTCs
nationwide for intensified TB case finding and reporting,
and set the ground for better monitoring and evaluation
jointly by the two programmes with a new monitoring
framework and revised reporting formats and
mechanisms.
Intensified TB-HIV package has been introduced in the
entire country in 2011.In 2011 with close to 7 lakh TB
suspects identified and tested for TB in HIV care settings;
of them, close to 84,000 TB cases were diagnosed and
linked to TB treatment services. Among the 23 states
reported in 2011, close to 6 lakh TB patients were
ascertained for their HIV status (67% of TB patients
registered) and about 44,000 HIV-infected TB patients
were diagnosed.
Public Private Mix (PPM): RNTCP has involved over
1971 NGOs and 10,894 Private Practitioners. 150
Corporate Hospitals and 297 Medical Collages are
implementing RNTCP. The programme is having
successful partnership with IMA, CBCI, PATH, The
Union and World Vision India.
Advocacy, communication & social mobilization
(ACSM): An effective advocacy, communication & social
mobilization (ACSM) strategy is in place. As envisaged
under the Stop TB Strategy ACSM plays a major role, in
order to maintain high visibility of TB and RNTCP
amongst policy makers, opinion leaders and
community.Four regional level ACSM capacity building
workshops were held by the program, wherein key
functionaries in the field (STO, DTO, and implementing
NGOs).National and Regional ACSM capacity building
workshops were held in year 2011 to streamline the
efforts.
Operational research (OR): Second round of zonal
ARTI surveys were completed in 2011 and 7 Prevalence
Surveys were also completed and the results were
discussed and shared in a series of workshops at national
level in 2011. These results were used for the TB burden
estimation and impact assessment. 72 thesis proposals
and 14 OR proposals were approved by various Zonal
OR committees in 2011.In addition seven OR studies
were approved by National OR Committee of which 2
have been completed and five are ongoing.
Impact of the programme: TB mortality in the country
has reduced from over 39 per hundred
thousandpopulation in 1990 to 29 hundred thousand
population in 2010 as per the WHO Global TB Report
2011. The prevalence of TB in the country has reduced
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