About RNTCP

Revised National Tuberculosis Control Programme (RNTCP)

 

 

                                                                                                                       

Last update : 31/03/2011

Link to Tuberculosis Control India

 

 

In India today,

like any other day this year, 
more than 1,000 people will die from tuberculosis (TB)
But

these deaths can be prevented.
With proper care and treatment

TB patients can be cured
and the battle against TB can be won

 

Tuberculosis (TB) is an infectious disease caused by a Bacterium, Mycobacterium tuberculosis. It is spread through the air by a person suffering from TB. A single patient can infect 10 or more people in a year.


India has a long and distinguished tradition of research in TB. Studies from the Tuberculosis Research Centre in Chennai and the National Tuberculosis Institute in Bangalore provided key knowledge to improve treatment of TB patients all around the world.


Modern anti-TB treatment can cure virtually all patients. It is, however, very important that treatment be taken for the prescribed duration, which in every case is a minimum of 6 months. Because treatment is of such a long duration and patients feel better after just 1-2 months, and because many TB patients face other problems such as poverty and unemployment, treatment is often interrupted.


Therefore, just providing anti-TB medication is not sufficient to ensure that patients are cured. Today, for the first time since the discovery of the first anti-TB medicines in 1944, there is hope of stopping TB. This breakthrough is a strategy known as DOTS, an acronym for Directly Observed Treatment, Short-course. 


The Director-General of the World Health Organization has declared that, "The DOTS strategy represents the most important public health breakthrough of the decade, in terms of lives which will be saved."

         
 

Directly Observed Treatment, Short-course (DOTS)


 
In 1992, the Government of India, together with the World Health Organization (WHO) and Swedish International Development Agency (SIDA), reviewed the national programme and concluded that it suffered from managerial weakness, inadequate funding, over-reliance on x-ray, non-standard treatment regimens, low rates of treatment completion, and lack of systematic information on treatment outcomes. As a result, a Revised National Tuberculosis Control Programme (RNTCP) was designed. DOTS is known as the Revised National Tuberculosis Control Programme (RNTCP) in India and is a comprehensive strategy for TB control.

 

The goal of RNTCP is to cure at least 85% of new smear-positive cases of tuberculosis and to detect at least 70% of such patients, after the desired cure rate has been achieved. Clearly, both good outcomes and high case detection rates are essential. But it is essential that the system is geared up to reliably cure patients, before any attempts are made at expanding case detection. In fact, experience clearly shows that reliably curing patients results in a “recruitment effect” – wherever effective services are offered, case detection rates steadily increase. Cured patients act as one of the best motivators promoting case detection and patient adherence to treatment.


DOTS is the only strategy which has proven effective in controlling TB on a mass basis. To date, 148 countries are implementing the DOTS strategy. India has adapted and tested DOTS in various parts of the country since 1993, with excellent results, and the RNTCP now covers more than 1 billion populations in over 564 districts in 29 states and union territories. The entire Country now covered by Revised National Tuberculosis Control Programme, making it the second largest such programme in the World. The programme has developed a ‘strategic Vision for TB Control for the Country up to 2015; under which it aims to achieve  and maintain a Cure Rate of at least 85% in New Sputum Positive Pulmonary TB Patients, and detection of at least 70% of such cases.

  

DOTS is a systematic strategy which has five components

 

Political and administrative commitment. TB is the leading infectious cause of death among adults. It kills more women than all causes associated with childbirth combined and leaves more orphans than any other infectious disease. And, since TB can be cured and the epidemic reversed, it warrants the topmost priority, which it has been accorded by the Government of India and the state governments. This priority must be continued and expanded at the state, district and local levels.
 

Good quality diagnosis. Top quality microscopy allows health workers to see the tubercle bacilli and is essential to identify the patients who need treatment the most.
 

Good quality drugs. An uninterrupted supply of good quality anti-TB drugs must be available. In the RNTCP, a box of medications for the entire treatment is earmarked for every patient registered, ensuring the availability of the full course of treatment to the patient the moment he is registered for treatment. Hence in DOTS, the treatment will never fail for lack of medicine.

 

The right treatment, given in the right way. The RNTCP uses the best anti-TB medications available. But unless treatment is made convenient for patients, it will fail. This is why the heart of the DOTS programme is "directly observed treatment" in which a health worker, or another trained person who is not a family member, watches as the patient swallows the anti-TB medicines in their presence.

 

Systematic monitoring and accountability. The programme is accountable for the outcome of every patient treated. The cure rate and other key indicators are monitored at every level of the health system, and if any area is not meeting expectations, supervision is intensified. The RNTCP shifts the responsibility for cure from the patient to the health system.

 

 

STATUS OF RNTCP IN MADHYA PRADESH

 

In Madhya Pradesh Revised National Tuberculosis Control Programme started in 1995 as Pilot Project in Master Lal Singh Hospital and Bairagarh Hospital. In 1998 this programme was implemented in Bhopal and Vidisha districts. Districts  Rajgarh, Sehore and Raisen started service delivery by third quarter 2001. This was the first phase in which 5 districts started the programme.

 

The entire state covered under RNTCP to provide services as per RNTCP guidelines by December 31st 2004.

 

In order to achieve this, each district has a district TB center. A Tuberculosis Unit (TU) covering 5 lakh population and a Designated Microscopy Center (DMC) covering  1 lakh population have been established for effective management of RNTCP. More than 3000 Medical Officers, 1000 laboratory technicians, 17000 health care workers and other community volunteers have been trained. More than 700 laboratory Microscopy Centers have been upgraded, established and fitted with binocular microscopes since the inception of the RNTCP to provide easy and optimum access to diagnosis and treatment facilities for suspected Tuberculosis Patients.  About Fourteen Thousand treatment observation points have been established to facilitate directly observed treatment nearest to the patients. Publicity and IEC of the programme providing treatment for tuberculosis patients has been taken to grass root level to apprise the community of the facilities under RNTCP.

 

 

    

ACHIEVEMENT 

 

In the Year 2010, (January to December 2010) 30,804 New Sputum Positive Patients Registered for Treatment out of which 27,114 patients Cured and remaining patients are under treatment.

                                                                                              

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