RIHFW Kashmir
Orientation Training of Medical Officers on RNTCP
Tuberculosis has been one of the oldest enemies of mankind, and has been recorded in all civilizations. Despite 100 years of effective treatment the disease has not shown a significant declining trend. Emergence of HIV/ AIDS has, on the contrary, led to a new rise in the incidence of tuberculosis all over the world. Even the countries which seemed to have conquered TB are now reeling under the mounting pressure of multi-drug resistant tuberculosis.
In India not less than 14 million people suffer from active tuberculosis, of whom 3.5 million are highly infectious. While about 5 lakh patients die of the disease, about 20-25 lakh new cases are added each year to the Indian pool. The National Tuberculosis Programmme has been in operation since 1962, which is now integrated with the general health services through the District TB Programme. In a district, the programme is implemented through the District TB Centre (DTC), and out of the 496 districts in the country, 447 have already established DTC's.
Continuous monitoring and subsequent evaluation of the NTCP in 1992 revealed that the results were not at all satisfactory. Accordingly the revised programme - (RNTCP) - was launched in 1993 in 5 project sites with the World Bank assistance. The initial results showed a sputum conversion of over 85% and a cure rate of over 80%. Encouraged by the results, the revised strategy was expanded to 17 sites thereafter. The Govt. of India proposes to seek world bank assistance for supporting RNTCP in 102 districts in 15 States covering a population of 271.12 million. In the Kashmir province, District Srinagar and Anantnag are being brought under the revised strategy, and training of the medical officers and the paramedics is on. A number of workshops are being conducted all over India to sensitize NGO's, private practitioners and government doctors for implementation of the revised strategy. The first such workshop was held in the Regional Institute of Health, Dhobiwan, on 23 March 2001 in which 87 district TB officers, community health officers, senior medical officers, voluntary organizations and private practitioners participated. In addition to the in -house faculty, many resource persons and facilitators were invited from Directorate of Health Services, the TB Demonstration-cum-Training Centre, and the DTC Srinagar. The topics covered included epidemiology and bacteriology of tuberculosis; the National TB Control Programme and the Revised Strategy (RNTCP); the emerging drug-resistance and its management; and the role of the peripheral doctor(private, government) in the control of TB. The sessions were followed by open discussion to clarify doubts and misconceptions.
Table IX: Workshop on revised National TB Control Programme and Multi drug-resistant TB
(Training Curriculum)
- Tuberculosis: Epidemiology - global and country scenario, recent trends and implications for general health services
- NTCP: Successes and failures; Revised strategy and approaches - the RNTCP
- Sputum examination - The main diagnostic tool; practical consideration: Art and science of sputum examination
- Anti-TB therapy: Modern approaches; DOTS and S.C Chemotherapy
- Multi-drug resistance TB; implications and related management issues
All over the world, April 24 is commemorated as the 'World TB Day' to impress that TB continues to be the chief public health problem in most developing nations including India. Our Institute has been holding inter-sectorial workshops on this day since 2000. In the workshop held on 24 April 2002 in which 93 senior and middle-level health administrators practitioners participated. In the last year's 'World TB Day' (ie 24 April 2003) some 175 participants attended the workshop on sputum microscopy.