Along with the early diagnosis of all TB cases and appropriate treatment, screening for comorbidity, appropriate management of comorbidity and periodic clinical review of TB patients is of utmost importance in order to improve TB treatment outcomes.
In order to ensure screening for comorbidity, appropriate management of comorbidity and periodic clinical review of TB patients a coordination mechanism is essential. Adapting the learnings from the TB-HIV collaborative framework, the National Strategic Plan (NSP) 2017-2025 recommended the setting up of the National TB Comorbidity Coordination Committee to address various comorbidities affecting the TB treatment. Subsequently, the State and District TB comorbidity Coordination Committees (DTCCs) were established.
The Programmatic Management of Drug-resistant Tuberculosis (PMDT) treatment book is a document that is issued to all patients who are diagnosed with DR-TB and are placed on a regimen for DR-TB. It is given in annexure 31 under the PMDT guidelines 2021.
Centres of Excellence (CoE) in HIV care were established with an objective to set up model treatment centres, impart high-quality training, and undertake operational and clinical research about HIV/ AIDS on a larger scale.
Structure and Activities of Centre of Excellence
Link ART Centre (LAC) aims for easy accessibility of treatment services for People Living with HIV (PLHIV) by reducing the distance, cost, and waiting hours for Anti-retroviral Treatment (ART) and thereby increasing treatment adherence. They are linked to a Nodal ART centre.
Anti-retroviral Therapy (ART) Centre is a facility to provide a comprehensive package of care, support and treatment services to persons living with HIV/AIDS (PLHIV).
Integrated Counselling and Testing Centre (ICTC) is a hub where HIV Counselling and Testing Services (HCTS) are offered to an individual of his/her own will or as suggested by a medical care provider.
Types of ICTC
1. Standalone ICTC (SA - ICTC)
2. Facility integrated ICTC (F - ICTC)
The SA-ICTC facility is a confirmatory facility and it should be located at an easily accessible place with proper signages to direct and guide people to the location.
The DR-TB HIV coordinator interacts with the TB patient care ecosystem as follows:
The roles of the Drug-resistant TB (DR-TB) HIV Coordinator are:
1. Providing technical assistance to District TB Officer (DTO) for:
Presumptive Drug-resistant TB (DR-TB) is identified by the health facility doctor during passive screening or by health staff/ community volunteers during Active Case Finding (ACF).
Prompt referral and sample collection is an important step after identifying presumptive TB/ DR-TB.