Quadrant -I (Video)
World Tuberculosis Day
Quadrant - II (Study Material)
1. World Tuberculosis Day
World Tuberculosis Day Each year we commemorate World TB Day to raise public awareness about the devastating health, social and economic consequences of tuberculosis (TB) and to step up efforts to end the Global TB epidemic .The date marks the day in 1882 when Dr. Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease. World TB Day observed annually on March 24, amplifies the urgency of ending tuberculosis—the world’s deadliest infectious disease. TB continues to devastate millions globally, inflicting severe health, social, and economic consequences. This year’s theme, Yes! We Can End TB: Commit, Invest, Deliver, is a bold call for hope, urgency, and accountability. Tuberculosis (TB) is an airborne infectious disease caused predominantly by Mycobacterium tuberculosis species of pathogenic bacteria. Tuberculosis is most commonly transmitted by inhalation of infected droplet nuclei which are discharged in the air when a patient with untreated TB coughs or sneezes. TB disease usually affects the lungs, but can involve any part of the body. Pulmonary TB which affects lungs is an infectious form of disease. Extra-pulmonary TB can affect the lymph nodes, pleura, bones and joints, the Genito-urinary tract, the nervous system (meningitis, tuberculoma), abdominal TB (intestines, mesentery, solid organs), skin, etc. All those who get infected do not necessarily develop TB disease. The life time risk of breaking down to disease among those infected with TB is 10–15%, which gets increased to 10% per year amongst those co-infected with HIV. Other determinants such as diabetes mellitus, smoking tobacco products, alcohol abuse and malnutrition also increase the risk of progression from infection to TB disease. Sputum Smear microscopy being the most commonly used method for microbiological diagnosis of TB for the last several decades. Under the programme, two methods of microscopy are currently being used- ZN stain-based microscopy using conventional microscope and Light Emitting. Culture though highly sensitive and specific method for TB diagnosis, requires 2-8 weeks to yield results. Culture will be used for follow up of patients on drug resistant TB treatment to detect early recurrence. In addition, it is also used for long term follow up for DS TB patients as per programme guidelines, to ensure relapse free cure. By Liquid culture system, Mycobacteria Growth Indicator Tube system (MGIT-B is an automated culture system detects the growth of mycobacteria. The culture results are usually available up to 42 days. DST results are available 14-26 days after the cultures turn positive. Molecular Assays– Polymerase Chain Reaction (PCR) based technologies using various modifications are used for detecting the presence of putative resistance genes. The most widely evaluated and used assays are Line Probe Assays (LPA) now available for RIF and INH resistance (MDR-TB) and also for XDR-TB (gyrA and gyrB for Fluoroquinolones, rrs(second line injectable) and eis(low level kanamycin resistance)for second line injectable). Nuclic Acid Amplification Test (NAAT) provides accurate and rapid diagnosis of TB by detectingNucleic Acid Ampli Mycobacterium tuberculosis (M. tuberculosis) and Rifampicin (Rif) resistance conferring mutations, in sputum specimen as well as specimen from extra-pulmonary sites. Chest X-Ray is to be used as a screening tool to increase sensitivity of the diagnostic algorithm. Any abnormality in chest radiograph should further be evaluated for TB including microbiological confirmation. Short course chemotherapy regimens have made it possible to treat and cure TB patients in as short a period as six months. Reduction in the duration of treatment regimens was possible because of the introduction of Rifampicin and Pyrazinamide. Treatment regimens of six months duration given daily have been found to be effective and achieve high cure rates, prevent emergence of drug resistance and minimize relapses. The shorter duration has contributed to improvement in the treatment adherence. Short course chemotherapy regimens of 6 months are recommended internationally for most forms of extra-pulmonary TB. The NTEP had adopted thrice weekly regimen for treatment of drug sensitive TB until the year 2016. Hence the programme has now shifted to daily regimen for treatment of all drug sensitive TB patients. The regimen for H & R sensitive TB cases during Intensive phase Isoniazid, Rifampicin, Pyrazinamide and Ethambutol given for 8 weeks (56 doses), and during Continuation phase, Isoniazid, Rifampicin and Ethambutol in daily dosages for 16 weeks (112 doses). India’s goal to eliminate TB by 2025 is one of the world’s most ambitious health missions. Under the National Tuberculosis Elimination Programme (NTEP), India has strengthened its TB response with advanced diagnostics, innovative policies, private sector partnerships, and a patient-first approach. Key drivers include record-high case reporting, better diagnostics, financial support for patients, and strong multi-sector collaboration. However, with global TB funding declining and shifting priorities, continued commitment is vital to meet India’s 2025 target and the UN’s goal of ending TB by 2030. Despite global efforts, TB remains a major public health challenge worldwide, with India bearing the highest burden. Understanding both the global and national estimates is key to gauging the scale of the disease and the urgency of India’s elimination mission. o tackle this significant burden, the Government of India has implemented a range of focused strategies under its National Tuberculosis Elimination Programme (NTEP). These key initiatives under NTEP aim to strengthen diagnosis, treatment, and prevention efforts, accelerating progress toward a TB-free India. National Tuberculosis Elimination Programme (NTEP) In 2020, the Government of India renamed the Revised National Tuberculosis Control Program (RNTCP) the National TB Elimination Program (NTEP). This reflects India’s goal to eliminate tuberculosis (TB) by 2025, five years before the global target of 2030. Here are the key targets for the Eradication of TB The NTEP follows the National Strategic Plan (2017-2025), focusing on four key actions: Detect – Treat – Prevent – Build (DTPB) to control and eliminate TB in India. According to WHO’s Global TB Report, India has made significant progress in fighting tuberculosis. Under the National Tuberculosis Elimination Programme (NTEP), the incidence rates of TB cases have dropped by nearly 17.7%, from 237 cases per 1 lakh people in 2015 to 195 in 2023. TB-related deaths have also reduced, falling from 28 to 22 per 1 lakh people during the same period. One of its key achievements has been reducing the number of missing TB cases from 15 lakh in 2015 to just 2.5 lakh in 2023 with a decrease of 83%. Under NTEP, India has rolled out improved drug-resistant TB treatments, including a safer, shorter all-oral Bedaquiline regimen, boosting success rates from 68% (2020) to 75% (2022). The mBPaL regimen (Bedaquiline, Pretomanid, Linezolid) offers 80% success for MDR-TB, cutting treatment to six months. Components Of the NTEP Programme 1. Pradhan Mantri TB Mukt Bharat Abhiyan (PMTBMBA) The Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA): Aims to unite communities, businesses, and institutions to support TB patients and their families. It focuses on providing nutritional, diagnostic, and vocational support to improve treatment outcomes, reduce illness and deaths, and fast-track India’s goal of TB elimination. PMTBMBA is also recognized as the world’s largest crowd-sourcing initiative for nutritional support to TB patients. 2. Ni-kshay Poshan Yojana (NPY) The NIKSHAY - TB Notification Incentive for the Private Sector, launched in 2018 by the Ministry of Health and Family Welfare, incentivizes private healthcare providers to report TB cases, improving TB surveillance and treatment. Under the Ni-Kshay Poshan Yojana, financial support for TB patients' nutrition has been increased from ₹500 to ₹1,000 per month, providing ₹3,000 to ₹6,000 per patient throughout treatment. The patient must be registered and notified on the NIKSHAY portal. The government has introduced Energy Dense Nutritional Supplementation (EDNS) for underweight TB patients (BMI < 18.5). Around 12 lakh patients will receive these supplements during the first two months of treatment to improve recovery rates and overall health outcomes. 3. Ni-Kshay Mitra initiative - Under the Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA), the Ni-Kshay Mitra initiative encourages individuals, NGOs, corporates, faith-based organizations, and others to adopt TB patients for at least six months, offering them nutritional, social, or economic support. The scope of this initiative has now been expanded to include food baskets for household contacts of TB patients, aiming to boost immunity, lower infection risk, and reduce families' financial burden. 4. Ni-kshay Portal Ni-kshay Portal is a web-based patient management and surveillance system under the National Tuberculosis Elimination Programme (NTEP). Developed by the Central TB Division, MoHFW, in collaboration with NIC and WHO India, it helps health workers in both public and private sectors to register TB cases, order tests, record treatment, monitor adherence, and transfer cases. It also serves as India’s National TB Surveillance System, ensuring real-time data reporting to the government.
2. World Tuberculosis Day
Book References · https://x.com/narendramodi/status/1853008149240066222 · https://www.who.int/campaigns/world-tb-day · https://www.who.int/campaigns/world-tb-day/2025 · https://www.who.int/news-room/fact-sheets/detail/tuberculosis · https://dghs.mohfw.gov.in/national-tuberculosis-elimination-programme.php#:~:text=Introduction,a%20result%20of%20TB%20disease. · https://www.instagram.com/mohfwindia/p/DCIwz7SNLzl/ · https://dghs.mohfw.gov.in/national-tuberculosis-elimination-programme.php · https://tbcindia.mohfw.gov.in/wp-content/uploads/2024/10/TB-Report_for-Web_08_10-2024-1.pdf - INDIA TB REPORT 2024 · https://pib.gov.in/PressReleasePage.aspx?PRID=2062928 · https://nikshay.in/Home/AboutUs · https://dashboards.nikshay.in/community_support/overview · https://nhmmizoram.org/upload/NTEPTrainingModules1to4.pdf
Quadrant - III (Assignments)
1. World Tuberculosis Day
Short Answer Questions on World Tuberculosis Day 1. Why is World Tuberculosis Day observed? 2. Who discovered the TB bacillus and when? 3. What is Nikshay, and what is its purpose in TB control in India? 4. What is the goal of the End TB Strategy? 5. How can medical colleges contribute to creating awareness about TB in the community?