Professional Documents
Culture Documents
Tuberculosis Control
Program (RNTCP)
Presenters
Masiya Debbarma
Naorem Kriyalaxmi Devi
N. Chingei Phem
Nevedita Das
Introduction
• Before 1940
– Sanatorium approach, good food, rest & fresh air
• 1948
– Introduction of BCG vaccination
• 1950s-60s:
– Antibiotics available
Background History of RNTCP
– 1906- First open air TB sanatorium founded in
India
– 1939- TB association of India
- expert advice on the development of
standard methods to deal with the disease;
- setting up model institutions for training TB
workers;
- education of the public regarding preventive
measures;
- conceived the idea of domiciliary Rx of TB
in 1940
• 1946- Bhore Committee recommended to the GOI, setting
up TB clinics in the districts and mobile TB clinics in rural
areas.
• 1947- GOI established a TB division under DGHS in the
MoH, Planning and execution of anti-TB activities were
greatly facilitated by this Division.
• 1951- Mass BCG vaccination campaign covering 65 million
children in collaboration with IUAT
• 165 million tuberculin tests were administered to find the
prevalence of TB in India
• 1955-58 - National Sample Survey conducted under
ICMR to find the magnitude of TB problem in India
Objectives
To achieve and maintain:
o Cure rate of at least 90% among newly detected smear
positive (infectious) pulmonary TB cases and
o Case detection of at least 85% of the expected new smear
positive PTB cases in the community
Organisational structure of RNTCP
Central TB Division, DGHS, Deputy Director General-TB
MoH&FW
National Lab Committee, National TWG for
National Institutes TB-HIV, National DOTS Plus Committee,
(NTI, TRC, LRS, JALMA) NTF for medical colleges, National OR
Committee
State TB Training and STO, MO, Epidemiologist,
Demonstration State TB Cell DEO etc
Centre/SDS/IRL
Nodal centre for TB control District TB Centre DTO, MO-DTC, Support staff etc
in the district
• Modular training
Category of
Type of Patient Regimen
Treatment
• Tab. Ethambutol
Sunday –
• Cap Cycloserine Unsupervised Oral Medicines
Inj Kanamycin OMITTED
• Tab Ofloxacin
• Inj. Kanamycin
CONTINUATION PHASE :18 months
• Tab Ethionamide
• Tab Ofloxacin
• Tab Ethambutol
• Cap Cycloserine
CAT V- XDR TB
XDR TB- MDR TB+ Resistant to Second line injectable Anti
TB drug & Fluroquinolone
The Intensive Phase (6-12 months) will consist of 7 drugs
Capreomycin (Cm), PAS, Moxifloxacin (Mfx), High dose-
INH, Clofazimine, Linezolid, and Amoxyclav
The Continuation Phase (18 months) will consist of 6 drugs
PAS, Moxifloxacin (Mfx), High dose-INH, Clofazimine,
Linezolid, and Amoxyclav
PROPHYLAXIS
• 3 tier system
National Reference Labs (NRL): 6 NRLs at present
1. Tuberculosis Research Centre (TRC), Chennai
2. National TB Institute, Bangalore
3. LRS Institute of TB and Respiratory Diseases, New
Delhi and
4. JALMA Institute, Agra
5. Regional Medical Research Centre, Bhubaneswar and
6. Bhopal Memorial Hospital and Research Centre, Bhopal
Intermediate Reference Labs: At State TB Training
and Demonstration Centres (STDCs)
Designated Microscopy Centres (DMCs): At the
periphery
Each NRL will supervise sputum microscopy EQA of
states designated under them
The NRL will ensure proficiency of RNTCP staff for
carrying out good quality diagnosis by providing
technical training to the STOs, STDC Directors,
Microbiologists and Lab Technicians of States
The states will designate 1 IRLs in the STDC or
Medical Colleges or in any Public Health Laboratory
of the State
The designated IRL will conduct sputum microscopy
EQA for the state and occasionally for a neighbouring
state or union territory
The IRL will provide technical training to district and
sub-district technicians and STLS
Sputum microscopy diagnostic services under
RNTCP are provided by DMCs established for every
1 lakh population (50,000 population in tribal, hilly
and remote areas)
In addition, the DMCs are also established at Medical
Colleges, Corporate hospitals, ESI, Railways, NGOs,
large private hospitals and other major hospitals
Quality Assurance (QA) for smear microscopy: It includes
1. Internal Quality Control (IQC)
2. External Quality Assessment ((EQA)
3. Quality Improvement (QI)