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Field supervision of Active Case Finding (ACF) is needed during both the preparatory phase and the implementation phase. Supervisory teams should be formed at the National, State, District, Block and Peripheral Health Institute (PHI) levels.
Field supervision during the preparatory phase:
The Field Supervisors should:
The ACF campaign has to be reported for documentation, monitoring and evaluating the performance of the activity and guiding the policy decisions.
The various formats used for reporting of performance of Active Case Finding (ACF) activities are as follows:
1. Field activity daily report
Table 1: Format for field activity daily report
Mapping of vulnerable population is a pre-requisite for conducting an efficient ACF campaign. It involves understanding the population characteristics, identifying and enumerating and mapping the target population.
Guidelines for mapping
Active Case Finding (ACF) is a provider-initiated activity with the primary objective of detecting TB cases early by active case finding in targeted groups and to initiate treatment promptly.
Medical colleges in the country are integrated with the National TB Elimination Programme (NTEP) to widen access and improve the quality of TB services. Medical colleges provide specialized services for seriously ill TB patients.
The integration of medical colleges in the program is in a structured task force mechanism at different levels:
Integrated patient-centred care and prevention are one of the pillars of the End TB strategy. This requires TB services to be made affordable and accessible by integrating them with the general health system.
In 2005, the National Rural Health Mission (NRHM) was established and was merged with the National Urban Health Mission (NUHM) in 2013, to form the National Health Mission (NHM).The National TB Elimination Programme (NTEP) is a flagship programme under the NHM and fund allocation to NTEP occurs through the NHM.
The public health system in India through the National Health Mission (NHM) visualises the attainment of Universal Health Coverage (UHC) for all its citizens, which provides access to equitable, affordable and quality health care services, which is also accountable and responsive to the needs of the people.
All childhood TB patients’ sputum and other relevant samples (e.g. gastric aspirate, induced sputum, bronchoscopic lavage, lymph node aspiration, CSF, tissue biopsies etc.) should be subjected to genotypic or the phenotypic Drug Susceptibility Tests (DSTs). Based on the bacteriological confirmation, the child should be treated for DS/DR TB as required.
But in cases where the child’s DST is unknown, the source patient’s DST should be considered.
Drug-resistant TB (DR-TB) diagnosis is predominantly based on laboratory diagnosis. Presumptive-TB/ DR-TB is identified by the health facility doctor during passive screening or by health staff/ community volunteers during Active Case Finding (ACF).
The vision of National TB Elimination Programme (NTEP) is to provide early diagnosis to all persons with any form of DR-TB through Universal Drug Susceptibility Testing (UDST).
N95 respirators are Personal Protective Equipment (PPE) used as a biosafety measure in clinical and laboratory settings.
N95 Respirators