Revised National Tuberculosis Control Programme - Part II / RNTCP - II. / Community Health Nursing.

The Phases of RNTCP
A. The Pilot Phase - (1993 - 1996)
B. The Phase I - (1997 - 2006) / DOTS intensification phase
C. The Phase II - (2006 - 2011) / Stop TB strategy Phase (Oct. 2006 -
Sept.2011)
D. Phase III - Universal Access / National Strategy Plan Phase (2012 -
2017 - Control and 2017 - 2025 - Elimination)
B. The Phase I - (1997 - 2006)
Objectives
i. To detect at least 70% estimated cases of TB
ii. To achieve at least 85% cure rate among newly detected sputum
smear positive cases.
• The focus was on ensuring expansion of quality DOTS services to the
entire country.
Revised Strategy - RNTCP - 1
1. Augmentation / expansion of organizational support at centre and
state. (LINK)
2. Use sputum testing as primary method of diagnosis
3. Standardized treatment regimen - (DOTS - WHO internationally
recommended)
4. Ensuring regular, uninterrupted supply of drugs.
5. Emphasis on training , IEC, operational research & NGO involvement
6. Increased budget outlay.
1. Organizational Structure of RNTCP. \
A. Central Level
- Central TB Division (CTD) in MOHFW.
B. State level
a. State Tuberculosis Control Society (STCS)
b. State TB Training & Demonstration Centers
C. District level
a. DTC (District Tuberculosis Centre)
b. District TB Unit ( DTU)
D. Sub District level
i. Designated Microscopic Centre ( DMC)
ii. Peripheral Health institutions (PHIs) / DOT Centres.
2. Diagnosis of Tuberculosis in RNTCP
Cough for 2 weeks or More
2 Sputum Smears - Sputum Microscopy
If 1 or 2 Positive - Smear Positive TB - Anti TB Treatment - DOTS
If 2 Negative,
Antibiotic for 10-14 days
If Symptom persists - Repeat 2 Sputum Smears - Sputum Microscopy
If 1 or 2 Positive - Smear Positive TB - Anti TB Treatment - DOTS
If 2 Negative - Chest X-ray
If negative - NON TB
If Positive - Smear Negative TB - Anti TB Treatment - DOTS
3. Standardized treatment regimen - DOTS
WHO internationally recommended
The most systematic and cost effective approach to increase the treatment completion rates of TB.
C. Phase II (2006 - 2011) / STOP TB Strategy Phase.
Aims
1. To consolidate, maintain and further improve / sustain the achievements of the phase I.
2. To maintain at least a 70% case detection rate.
3. To maintain a cure rate of at least 85%,
Components
1. Pursuing / following Quality DOTS - Expansion and enrichment.
2. Enabling and promoting research ( Diagnosis, Treatment and Vaccine)
3. Addressing TB/HIV and MDR-TB
4. Contributing health system strengthening
5. Engaging all care providers.
6. Empowering patients and communities.
The emphasis / Design / Strategy of Second Phase of RNTCP
1. To strengthen the quality of the DOTS
- through quality assure service protocol for sputum microscopy.
2. To provide services for marginalized groups
- such as urban slum dwellers and tribal groups etc.
3. Rational use of standardized Ist and IInd line anti-TB drugs
4. Need based advocacy communication and social mobilization - to generate awareness.
5. Quality assured diagnosis and treatment
- through Schemes to increase the participation of private sector providers and also
6. Inclusion of DOTS+ for MDR -TB and XDR TB and
7. Systematic research and evidence building
ACTIVITIES of Second Phase
1. Increase access of services to hard-to-reach areas.
2. Strengthening the intersectoral collaboration
3. Scaling up of the state level Intermediate Referral Laboratories capacity (to increase something in size, amount, or production)
4. implementation of DOTS-PLUS for MDR-TB cases in a phased manner
5. Distribution of paediatric drug boxes
6. Institutional strengthening at national, state and district level
7. Introduction of TB-HIV co-ordinator,
8. Urban co-ordinator and communication facilitator.
4. DOTS-PLUS (DOTS +) strategy
• Launched by WHO in 2000 and by RNTCP
in India during 2007.
• DOTS-Plus is DOTS programme that adds components for diagnosis
and treatment of Multi-Drug-Resistant Tuberculosis (MDR-TB).
• It is a Programmatic Management of Drug Resistance TB (PMDT)
• DOTS + programs have proven to be a good option for proper
treatment of MDR-TB in poor, rural areas.
Laboratory Network - RNTCP
• RNTCP established a nationwide Laboratory network.
- DMCs (Designated Sputum Microscopy Centres at district level),
- Intermediate Reference Laboratory (IRL) at state Level, and
- National Reference Laboratory (NRL) at National Level.
RNTCP endorsed TB diagnosis
a. Sputum Smear Microcopy for Acid fast bacilli
b. Rapid Diagnostic Molecular Test
i. Conventional PCR based Line Probe Assay for MDR-TB
ii. Real time PCR Nucleic Acid Amplification Test (NAAT)
iii. Others.
Thank You.

[@sudeshnanath4410]

Thank you so much sir for your videos🌼🌼🌼🌼...I download them nd watch on repeat mode.....waiting for the next video eagerly😌 this one is in our syllabus

[@Angelhealthacademy]

Certainly, with pleasure

[@thesumanprabha]

Exams are there .... Please upload 3rd and 4th part

[@unnikkannanm7477]

Thank you so much Sir for the great effort.🙏

[@Angelhealthacademy]

With pleasure Kannan

[@jyothsanamathews3945]

Sir can u upload 3rd part of rntcp soon..

[@Angelhealthacademy]

Sure Jyothsana

[@mumthasbeegam3422]

Sir part 3and part 4class ille

[@Angelhealthacademy]

Ok, will do, Mumthas

[@lakshmiwaghmare7813]

Sir part 3 and 4

[@Wmindia]

Hi sir need your kind advice I had tuberculosis in 2015 and took AKT for 9 months and cured and it left a scar in my lungs.
As I'm applying for the Canada visa because of scars i got furtherence examination instructions for TB
I have given my 3 sputum samples for 3 days in the morning (fasting) but my last sputum sample was discoloured because I ate paan masala at that night.
I'm worried because the lab technician may misunderstood that reddish sputum with blood which was actually due to pan masala I ate.
Can you please give your valuable advice will my discoloured sputum cause any issues with the results?
Thank you
Kind regards

[@Angelhealthacademy]

Very nice to here from you, there is no need to worry about discoloration of sputum, that doesn't make any changes in the result of sputum smear test, because it detect the presence of acid fast bacillus, that confirm the diagnosis of TB. So all the very best for the future endeavours.

[@Wmindia]

@@Angelhealthacademy thank you sir