Approach

1. Direct participation in TB control

2. Capacity building

3. Advocacy, Communication and Social Mobilization (ACSM)

4. Research activities – Field / laboratory

5. Publications

Beginnings

In March 1996 a joint leprosy/TB/AIDS awareness programme has been taken up as a pilot study, in a part of Jeypore sub-division, covering a population of 2.61 lakhs.

The main objectives were to devise an appropriate strategy for implementation of a joint programme by involving the staff of PHIs and Anganwadi workers in the implementation of DOTS. In the pilot study 263 sputum cases were treated with 87% cure rate.

Further….

• Since 1998 the treatment of TB patients has been done in the pattern of RNTCP by utilizing the general health care staff. TB medicines are procured from DANTB. Since 1999 the programme has been extended to entire Jeypore sub-division covering 5 lakhs population. 1368 TB cases were treated until launching of RNTCP in the district. 86% cure rates are achieved.
• Sputum Microscopy and DOTS components have been established in projects and routine IEC activities under the Revised National Tuberculosis Control Programme (RNTCP) like sensitizing community and private health providers about DOTS and RNTCP have been undertaken. The District TB control officers in AP, Orissa, Bihar and MO requested participation of LEPRA India projects in RNTCP since 2001. The main areas identified was to establish and implement designated microscopy centers (DMCs), Sputum collection centres (SCCs), Tuberculosis Units (TUs), LT scheme and Culture & Drug Sensitivity Testing (C&DST) NGO schemes under RNTCP.

*not under signed RNTCP schemes for NGOs

LEPRA India geographically covers in providing direct TB services to 5.3 million populations in 4 states namely AP, MP, Odisha and Bihar, ACSM activities in 32.7 million MP covering 19 districts of Odisha and MP together and DOTS Plus CDST activities in 17 million covering 4 coastal districts in AP. The direct services cater to the Hard to reach/needy areas in rural, tribal and urban population. The sputum collection centers improve access. TB HIV co-infection addressed by integrated work of ICTC and DMCs and introduction of ORWs to enhance TB and HIV cross referrals. Introduced Patient friendly services with enabling atmosphere and Patient Charter are translated in Oriya, Hindi and Telugu. The data review and management is done by analysis of performance indicators and review of performance and progress of DMCs/TUs on periodical basis. In the intervention areas focus is to mobilize the local communities and stakeholders to enhance the TB related awareness.

Some of the best practices initiated:

The performance indicators in 2010 are the annualized case detection rate was 149/lakh per year (target is 142/lakh/year) with new sputum positive case detection at 60%. About 5694 TB cases were diagnosed and initiated on DOTS and followed up. From the above, 396 new sputum positive cases were diagnosed among 4129 TB suspects examined from the 190 sputum collection centres situated in Odisha and MP. The sputum conversion rate was 89–94% (target is 90%), treatment cure rate was 82 – 92% (target is 85%), death rate was 3-7% and defaulter rate was 3-6%. In 2010, TB HIV cross referrals increased and for this involvement and coordination with TIs of FSW, MSM, IDU and PLHA was established. About 527 TB-HIV cases were managed during the year. In AP 12 new MDR TB cases were diagnosed and put on Cat IV treatment, for which our staff support in treatment adherence.

Capacity Building