National TB Elimination Programme (NTEP)

National Tuberculosis Elimination Programme (NTEP), previously named as Revised National Tuberculosis Control Programme (RNTCP) is the Public health initiative by Government of India that has a mission to eliminate TB by 2025. RNTCP (1997) was changed to NTEP in 2020. The tagline of the Programme is “ TB Harega Desh Jeetega”.

Targets

• Elimination of TB by 2025
• To reduce mortality of TB by 90%
• To reduce incidence of TB by 80%

Also Read: Asha: Accessibility, Functions, Obligations, Compensation, Benefits And Facilitators of Asha

National Strategic Plan for TB Elimination

• This plan was launched in 2017 and the target is to eliminate TB by 2025.
  • Vision
  • TB free India
  • 0-death, 0-disease, 0-poverty.
• Strategy
  • Detect- Treat- Prevent
  • Efforts are made to universalize the CB-NAAT. If there is anyone with history of cough >2 weeks will be called as presumptive TB case and CB-NAAT is done at baseline.
  • TRUENAT developed by ICMR is an Indian version of CB-NAAT . This test gives results for Rifampicin resisitance within 1 hour.
  • New drugs like Bedaquiline and Delamanid are introduced.
  • Shorter and Longer oral MDR/XDR regimens are introduced.
• JEET strategy (Joint Effort for Elimination of Tuberculosis)
  • The main reason for starting this is, non-notification by private practitioners and TB is still not completely eliminated.
  • The strategy is to increase the notification rates of TB by private practitioners.
  • Indian organizations, Ministry, NGO’s and International organizations are working together to eliminate TB.

Also Read: Screening of Disease

Case Detection

Active case Detection

• House to house search for TB cases
• ASHA workers are invloved and will get incentive of Rs.500 for finding a presumptive case.
• Any member in the community who helps finding a presumptive case gets an incentive of Rs.500.
• Vulnerable groups are slum dwellers, prisoners, difficult to reach population , Migrants, tribals, Shelter homes etc.

Intensified case finding

• Provider initiated screening of TB symptoms in OPD.
• Patients presented to the health facilities with other comorbidities will be screened for TB.

Community based Screening

• ASHA worker fills a community based assessment checklist (CBAC) form, asking the risk factors for diabetes along with TB.
• She gets Rs. 10 per form filled.

Passive case detection

• Passive Surveillance from the hospital reports.

Presumptive TB case

• Any person with cough >2 weeks duration or more.
• Negative test-repeat testing till 2 months and confirm HIV status by 2 years.
• An individual having fever or night sweats or appreciable weight loss of 2 weeks or more.
• Contacts of a smear positive TB patient having a cough of any duration.
• Suspected / confirmed extra pulmonary TB having cough of any duration.
• HIV positive patients having coughs of any duration.

Also Read: Classification Of Epidemiological Studies

Categories of TB treatment 

• Category I - Newly and previously treated TB patients.
• Category 4 - Multi Drug Resistant TB patients.
• Category 5 - Extensive Drug Resitant TB patients.

Incentives under TB

Nikshay Poshan Yojana

• Nutritional incentives of Rs.500/month given to all notified TB cases/patients.
• An Aadhar linked transfer.
• Includes patients notified by private practitioners also
• For tribal patients, incentive is Rs.750.

Incentives to treatment supporters

• DOTS provider who ensures treatment completion of New and previously treated case, Rs 1000 is given and for Drug Resistant TB case, Rs.5000 is given.

Incentives for private practitioners

• On notifying a case of TB - Rs.500
• On notifying treatment completion - Rs.500
• Total incentives for complete case is Rs.1000
• Can notify a TB case upto 30 days.
• If fails , it is punishable offense under IPC 269 and 270.

Other Technology based Initiatives

• NIKSHAY- An online software, for reporting and compliance of treatement.
• DOTS-99
• MERM Container Box- GPS enabled box . It detects when the patient has taken the medicine and informs the NIKSHAY portal.

Also Read: The Spectrum of Disease and The Iceberg Phenomenon

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