|DISTRICT TUBERCULOSIS CONTROL PROGRAMME IN CONCEPT
|DR Nagpaul: Indian J TB 1967, 14, 186-98.
This is a conceptual account of the District Tuberculosis
Control Programme. The District Tuberculosis Programme (DTP) was
formulated by the National Tuberculosis Institute in 1962 to form
the basis of a community-wide programme to deal with the challenge
of a large, predominantly rural tuberculosis problem in the country.
The limited resources in the form of funds, trained personnel and
equipment, made it necessary that the programme be simple, easy
to apply and widely acceptable.
The DTP includes provision for tuberculosis Case-finding, treatment and prevention throughout the district from the
health institutions in an integrated manner. Case-finding is carried
out among the symptomatics attending the health institutions primarily
by sputum examination and treatment is offered on ambulatory domiciliary
basis. District Tuberculosis Centre (DTC) represents the
pivot around which the integrated DTP revolves. DTC takes up all
the responsibilities in respect of the programme on behalf of the
District Health Authority. It undertakes planning, implementation,
coordination and supervision of the DTP in the entire district besides
offering the usual diagnosis and treatment service to the population,
under its direct care. Health institutions other than DTC which
participate in the DTP are called "Peripheral Health Institutions"
(PHIs). These are categorised into "Microscopy Centres"
and "Referring Centres" depending upon possession
of microscope or otherwise. Both categories are full-fledged "Treatment
Centres". Sputum examination is offered to all chest symptomatics
reporting at "Microscopy Centres" and if found positive
for AFB the patient is motivated and put on treatment immediately.
DTC maintains the important "District TB Case Index"
and offers "referral" X-ray examination to the sputum
smear negative symptomatics referred by the "Referring Centres".
One BCG Vaccination Team also works under DTC. There is one DTC
in a district and the already existing TB clinics become just one
of the PHIs under one DTC. Key staff consisting of a District Tuberculosis
Officer (DTO), a Treatment Organiser (TO), a Laboratory
Technician (LT), an X-ray Technician (XT), BCG
Team Leader and a Statistical Assistant (SA) are required
to provide service from the DTC and to organise the programme of
Case-finding and treatment in an integrated manner throughout the
district from all available institutions of General Health Services.
|KEY WORDS: DTP, DTC, PHI, INTEGRATION.