What IMA can do to the success of RNTCP DOTS

IMA APSTATE GFATM RNTCP UNIT-I workshop/ review meet was well organized by Dr.G.S.MURTY & DR.P.S.SARMA IN KAKINADA ON 30-1-11,which was actively participated by all stake holders.

contribution of IMA towards success of RNTCP methodology in fighting against T.B. is well appreciated by one and all.

My observations and submissions to the meet :

• It’s wonderful that we have treated 1.3 crore patients and averted almost 20lac deaths since we have started RNTCP in 1997.

• It’s also pleasant to hear the words of K.S. Sachdeva, Deputy Program Manager, Central TB Division that we have achieved case -detection rate of over 73 per cent and a treatment success rate of over 87 per cent in 2010 against the global benchmark of 70 and 85 per cent respectively.

• Its heartening to note that we have 19 labs having equipped to do newer “molecular-based Line Probe Assay”, which can diagnose MDR-TB in 48 hours as compared to 6-12 weeks taken by conventional tests.

But still there are more challenges lurking to get our serious attention -

A. multi-drug resistant TB (MDR-TB) and

2. TB-HIV co-infection and
3. Another big hurdle is lack of coordination between functional dynamics of public and private players.

D. Still, irrational treatment is the main culprit in emergence of MDR-TB

So,what should the govt. do?

1. Addressing and implementing the program in cemonk centers,geriatric ashrams,paediatric hospitals.

2. The current diagnostic test - sputum microscopy -for TB has been used for 125 years and its not ideal because it doesn’t easily detect the growing number of strains that are resistant to antibiotics, or TB where the patient is also infected with HIV. We have to introduce newer diagnostic test promoted by Dr. Mario Raviglione, Director of the WHO’s Stop TB department which delivers a result in 100 minutes.

3. “Unfortunately, the antibiotics we use to fight TB aren't effective against latent TB and can only be used when the disease becomes active. This is a major problem as 1 out of 10 people who have latent TB will develop the active disease, becoming sick and contagious.”

“If we can figure out a way to treat TB when it's in a latent stage, then we could save millions of lives throughout the world.”

some suggestions to improve this prestigious PPM project are-

What IMA can do?

1. Peer to peer re-sensitization program which will give better results by converting more private physicians in to referral doctors and DOT providers.

2. Involving local IMA branches to establish DMC. By this,we can mitigate apphrensions of private doctors of loosing patients thus involve more private doctors to adhere to the concept of RNTCP.

3. APPOINTING local mobile sputum collector –to collect specimens, to process and to deliver the reports to doctors in a stipulated area.