C: Programme Formulation
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.