REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME
Tuberculosis is a major health problem in India caused by Mycobacterium tuberculosis. One sputum positive patient can infect 10-15 persons in a year, if left untreated. Every day, more than 1000 persons die from TB in India, 4 lakh per year, 2 persons every 3 minutes. To fight with TB, The Revised National Tuberculosis Control Programme (RNTCP), based on the internationally recommended DOTS strategy was initiated in Haryana in 2000 in three Districts. The entire State of Haryana has been covered under RNTCP by the end of April, 2004.TB Diagnostic facilities and treatment facilities is absolutely free of cost in all the govt. hospitals.
Goal: To decrease mortality and morbidity due to TB and stop transmission of infection until TB ceases to be a major Public health problem in India
To ensure universal access to quality assured diagnosis and treatment for all TB cases in the Community.
Achievements under RNTCP
Ø Under the RNTCP more than 8121 Directly Observed Treatment (DOT) Centres/providers, 258 Microscopic centers & 119 TB Units are functioning under this program in the entire State.
Ø Programmatic Management of Drug resistant TB (PMDT) activities for the diagnosis and treatment of Multi Drug Resistant TB cases has been launched w.e.f. Dec 2008 and have been scaled up in whole state in November 2012.
Ø Intermediate Reference Laboratory (IRL) - Public health laboratory at Karnal has been upgraded to state level intermediate reference laboratory for diagnosing and keeping follow up of Multidrug resistant TB cases and is accredited under RNTCP by GOI in March 2011. It is providing free diagnostic services to all MDR-TB suspects.
1. CB-NAAT (Cartridge Based Nucleic Acid Amplification Test) Machine provides diagnosis of MDR –TB within two hours. PGIMS Rohtak and Government Medical College Mewat are delivering the diagnostic services for MDR-TB. It has been proposed that 7 new machines shall be installed in various districts of the state which will further enhance the diagnostic services under RNTCP.
2. LPA: Intermediate Reference Lab Karnal also diagnostic provision of Line Probe Assay(LPA) to detect sensitivity of TB patients to Rifampicin and Isoniazid within 3 days.
3. Under the PMDT, all the MDR-TB patients are also offered free baseline second line Drug Susceptibility test (DST) for sensitivity to Ofloxacin and Kanamycin.
Ø Notification of TB Cases: Tuberculosis has been declared Notifiable disease in India vide Government of India Order No.Z-28015/2/2012-TB dated 7th May 2012. Consequently the State has disseminated information in all the Health institution for its effective compliance. A web based case based on line TB cases entry has been ensured in Online NIKSHAY web portal. Private Doctors can also enter the details directly into mobile application of NIKSHAY and can notify TB cases to the RNTCP. NIKSHAY will also be utilized as monitoring and surveillance tool by all levels of program managers.
Ø TB-HIV Collaborative activities: Intensified TB-HIV package has been launched in Haryana since Oct.2010. State level TB-HIV coordination committee has been formed in 2014. Cross referral activities from ICTC to RNTCP and RNTCP to ICTC are being reviewed at district and state level. Effective RNTCP regimens are being used for the treatment of TB–HIV co-infected cases. Currently RNTCP in Haryana is testing around 80% TB patients for HIV before or during the TB Treatment and plans to cover 100% of TB patients with HIV testing.
Ø Involvement of Medical Colleges- Seven Medical Colleges of state (Rohtak, Mullana, Agroha, Gurgaon, Mewat, Sonepat & Faridabad) have been involved in RNTCP and are providing free diagnostic and treatment services to TB cases as per RNTCP guidelines. Medical colleges are also participating by providing expertise and reaserch. PGIMS Rohtak is also acting as DR-TB center and providing treatment to MDR-TB/XDRTB patients. State plans to scale up more DR-TB centers in such tertiary care institutes and utilize the expertise for betterment of RNTCP.
Ø Paediatric patient wise boxes are being provided free for Children with TB for DOTS in all the 21 districts of Haryana and for Paediatrics MDR TB cases in all the 21 implementing districts of Haryana in PMDT.
Partnership in the Programme – The project Axshay has been launched since October 2010, where in PSI and MAMTA are sub recipients of Union funded by GFATM, 12 districts are covered By MAMTA and 7 Districts by PSI under this project for ACSM activities. Project Axshya, through its innovative intervention focusing on advocacy, communication and social Mobilization, is strengthening the RNTCP to achieve its objective of Universal Access to TB services.
Districts under MAMTA
District Under PSI
1) Bhiwani, 2) Sirsa, 3) Fatehabad, 4) Panipat, 5) Faridabad 6) Ambala, 7) Hisar, 8)Sonepat, 9) Yamuna Nagar, 10) Gurgaon, 11) Rewari 12) Mahendergarh
1) Ambala, 2) Hisar, 3)Sonepat, 4)Yamuna Nagar, 5) Gurgaon, 6) Rewari 7) Mahendergarh
Ø Physical achievement of State Haryana under RNTCP Financial Year 2014-15
Number of chest symptomatics whose sputum was examined for diagnosis
Total Case detection
Annualized Total Case Detection Rate /lac/year
New Smear positive cases Detected
New Smear Positive Case Detection Rate /lac/year
Sputum Conversion rate of NSP patients of previous quarter
Success rate of New S+ve patients registered 12-15 months previously