Sr. DR-TB TB-HIV Supervisor

The concept of Patient Turnaround Time (P-TAT) is to find out how much time was taken from the identification of the patient for a test to getting the result of that test and initiation of patient's treatment based on the test result.

The National TB Elimination Programme (NTEP) have set benchmarks to monitor the P-TAT as provided in the table below. 

Under the National TB Elimination Programme (NTEP), the treatment outcome definitions of Drug-susceptible TB (DS-TB) and Drug-resistant TB (DR-TB) have been aligned in recent times. However, the treatment outcome is declared at different time points for certain outcomes (e.g., cured/ treatment completed) since the duration of DR-TB treatment is longer when compared to DS-TB treatment. 

The World Health Organization (WHO) defines palliative care as an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illnesses, through prevention and relief of suffering by means of early identification, impeccable assessment, and treatment of pain and other physical, psychosocial and spiritual problems.

The goal of such treatment is to improve the quality of life for both the patient and their family. 

The reconstitution of Bedaquiline (Bdq) bottle should be done at the State Drug Store (SDS).

In case of lost to follow-up/ death/ transferred-out/ treatment stopped patients, Bdq bottle shall be brought back from the treatment centre to the Health Facility (HF) to the TB Unit (TU) to the District TB Centre (DTC) within the shortest possible time.

Packaging of loose drugs into monthly patient-wise boxes should be done under the guidance of those in charge of drug logistics at the state and district levels.

Patient-wise drug box preparation should be done for the following Drug-resistant TB (DR-TB) regimens:

1. Shorter oral Bedaquiline-containing Multidrug-resistant/ Rifampicin-resistant TB (MDR/RR-TB) regimen
2. Longer oral Multi (M)/ Extensively Drug-resistant TB (XDR-TB) regimen
3. Isoniazid (H) mono/poly DR-TB regimen

Adverse Drug Events are classified on the basis of severity:

1. Serious Adverse Event (SAE) is any untoward medical occurrence that at any dose:

The National TB Elimination Programme (NTEP) utilizes different coloured bags for the segregation of waste generated in TB laboratory settings as shown in the table below.

Presumptive Drug-resistant TB (DR-TB) in Children

It occurs mostly in children who:

• Are contacts of adults with Multidrug-resistant (MDR)/ DR-TB
• Are lost to follow-up after initiating treatment
• Present with recurrence of disease after previous treatment
• Do not respond to treatment with first-line drugs
• Are Children Living with HIV (CLHIV).

To increase support for Tuberculosis (TB) patients coming from the private sector, the National TB Elimination Programme (NTEP) has affirmed that public health response to all TB patients notified from the private sector will be the responsibility of the public health system. ​

Patients support services like adherence support, drug susceptibility testing, comorbidity detection, recording treatment outcomes, and infection prevention measures are already being extended to patients in the private sector. ​

Persons with cough of more than 2 weeks, with or without other symptoms suggestive of TB, should be promptly identified as presumptive pulmonary TB patients.

Under NTEP, they are to be referred to the designated microscopy centre (DMC) for sputum examination using the Request form for examination of biological specimen.

Patients belonging to the key population EPTB, HIV and Paediatrics groups (after X-ray screening in case of children) can be directly referred for NAAT.