Kashish Grover, PSM Faculty
HIV TB Course
TB and NTEP
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SDGs and TB
The United Nations Sustainable Development Goals (SDGs) include ending the TB
epidemic by 2030 under Goal 3.
Goal 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected
tropical diseases and combat hepatitis, water-borne diseases and other communicable
diseases.
Dr. Kashish Grover, PSM faculty DAMS 2
END TB Strategy
Dr. Kashish Grover, PSM faculty DAMS 3
National Strategic Plan (2020-2025)
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Dr. Kashish Grover, PSM faculty DAMS 5
Tuberculosis Unit
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Dr. Kashish Grover, PSM faculty DAMS
Dr. Kashish Grover, PSM faculty DAMS 7
TB Case finding
Passive Case finding Active Case finding
It refers to a person-initiated It refers to the systematic
pathway to TB diagnosis. screening for active TB in at-risk
Intensified case finding is a populations, typically
component of passive case implemented outside the health
finding which involves facilities (community or
systematic screening of all congregate settings).
people seeking care in a
health facility or a clinic for Contact tracing is a component of
identification of people at active case finding.
risk for TB.
Dr. Kashish Grover, PSM faculty DAMS 8
Dr. Kashish Grover, PSM faculty DAMS 9
TB Prevention
• TB preventive treatment (TPT) for high-risk populations and
• Airborne infection control (AIC) in health care and other settings.
Dr. Kashish Grover, PSM faculty DAMS 10
TB Preventive Therapy
Whom to start
People living with HIV (+ ART) TPT to all after ruling out active TB disease
• Adults and children >12 months
• Infants < 12 months with HIV in
contact with active TB patient
• HHC below 5 years of pulmonary TB
patients
• HHC 5 years and above of TPT after ruling out TB disease among TBI positive*
pulmonary TB patients
*Tuberculin Skin Test (TST) and Interferon-Gamma Release Assay (IGRA)
• Individuals who are:
• on immunosuppressive therapy
• having silicosis
• on anti-TNF treatment
• on dialysis
• preparing for organ or
hematologic transplantation
Dr. Kashish Grover, PSM faculty DAMS 11
TB Preventive Therapy
Contraindications Regimens
1. Active TB disease 6H 3HP
2. Acute or chronic hepatitis
3. Concurrent use of other Drugs Isoniazid Isoniazid +
hepatotoxic medications rifapentine
4. Regular and heavy alcohol Duration 6 months 3 months
consumption
5. Signs and symptoms of peripheral Interval Daily weekly
neuropathy like persistent tingling,
numbness and burning sensation Doses 182 12
in the limbs
6. Allergy or known hypersensitivity Pregnant Safe Not known
to any drugs being considered for
With ART No restriction Restrictions
TPT
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TB Preventive Therapy
DRTB contact
6lfx 4R
Drugs Levofloxacin Rifampicin
Duration 6 months 4 months
Interval Daily Daily
Doses for contacts of R for contacts of H
resistant FQ resistant R
sensitive patients sensitive
patients
Dr. Kashish Grover, PSM faculty DAMS 13
Dr. Kashish Grover, PSM faculty DAMS 14
Call Centre Support Ni-kshay SAMPARK (1800-11-6666)
Patient support system
Direct Benefit Transfer (DBT): Amount
Ni-kshay Poshan Yojana (NPY) Confirmed TB Patients (DSTB &
DRTB)
Public + Private Sector Patients
Honorarium for Treatment Supporters Confirmed TB Patients residing in
Tribal/Hilly/Difficult blocks
Transport support for TB patients in Treatment Supporter
notified tribal/hilly/difficult areas
Notification & Treatment Outcome Private Health Facilities:
Incentive for Private Sector Providers Practitioner / Clinic etc. (Single)
including informants incentive: Hospital/ Clinic/ Nursing Home
Laboratories, Chemists
Any person as informants
TPT supporter ASHAs or Community Health
Volunteers
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Partnership under NTEP
• Provision of free diagnostics under NTEP
• Provision of government FDCs to the patients seeking care from private sector.
• Incentives for private providers for notification, treatment outcomes or referral (wherever
applicable).
• Incentives to patients seeking care from private sector in the form of Nikshay Poshan Yojana.
System for TB Elimination in Private Sector (STEPS) approach:
A single window solution is provided for notification, linkage for public health actions, and treatment
adherence support in private hospitals by identifying nodal persons from the health facility itself. This is
being practiced in Kerala and Karnataka
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Dr. Kashish Grover, PSM faculty DAMS 18
Community Engagement
Ni-kshay Mitra
• The Ni-Kshay Mitra shall provide additional
support to all the on-treatment TB patients
who have given consent for support.
• The support shall include the following:
a. Nutritional support
b. Additional investigations for the
diagnosed TB patients
c. Vocational support
d. Additional nutritional supplements
• The minimum period shall be six months.
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Thank You..!!
In case any doubt, feel free to connect
Dr. Kashish Grover
MBBS, MD (PSM)
Faculty DAMS
Instagram: @kays_psm
Telegram: @kays_psm
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