Sarin(Ind J Tub(1995,42,95)described the salient features of Revised National Tuberculosis programme.
The revised national TB control programme takes advantage of the technology revolution which took place by
the introduction of Directly observed Therapy(DOT) in countries like Tanzania,it was shown that DOT has reduced
the annual risk of infection(ARI) to 4-5 % and ,consequent to this ,it was estimated that there would be a reduction
in infectors(diseased) and infected(potential) by 50% in 15 years.
Objectives of revised NTP
- overall
- To reduce mortality and morbidity from tuberculosis
- To interrupt the chain of transmission of infection
- Operational
- To cure at least 85% of all newly detected cases of pulmonary tuberculosis with supervised short course
chemotherapy
- To detect at least 70% of the estimated incidence of smear positive pulmonary tuberculosis cases
However ,effort at increasing case detection would be made only after achieving 85% cure rate in the
already detected cases.
Strategy
To achieve the above objectives of the revised NTP ,the following strategy is being developed:
- To change the current practice of radiological diagnosis to diagnosis by sputum microscopy
- To treat all smear positive cases and seriously ill sputum negative cases with short course chemotherapy
direcly supervised in the intensive phase and appropriately supervised in the continuation phase ,through involvement of peripheral health functionaries.
- To make available the required antitubercular drugs in appropriate blister combipacks,uninterruptedly to all peripheral areas.
- To strenghten the capability of District Tuberculosis centre and State TB demonstration and training centresfor effective implementation,monitoring and evaluation of the programme including cohort analysis of patients under treatment
- Strengthening supervision beyond district level
- Augmenting training capabilities both at national and state levels
- Introducing a professionally managed Information,Education&communication(IEC)compaign
- Aim at involvement of NGO's and private medical practitioners
- Operational research
The revised strategy is in line with the recommendations made by WHO.Khatri(Ind J Tub 1999,46,157)reviewed the results of treatment of first 100000 patients put on treatment from October 1993 to March 1999.The quality of diagnosis was stated to be good,and treatment success achieved in
- 79% of both new smear positive and smear negative cases
- 88% of patients with extrapulmonary tuberculosis
- 67% of retreatment smear positive patients
It is stated that maintaining the quality of implementation during the expansion phase is the next challenge and all who care tuberculosis in the country are urged to help in this herculean task.