A study was conducted in 1983-84 by the National TB Institute (NTI) in the districts of Dharmapuri (Tamil Nadu) & Ananthapur (Andhra Pradesh). Thirteen health personnel were trained in census taking, tuberculin testing & reading and data keeping etc., at the NTI according to the standard methodology. The trainees were repeatedly assessed and only those who achieved a reasonably high inter-reader correlation with the standard reader were chosen for the field work. Field work was carried out by these health workers and supervised by the team leaders of NTI. Children between 0-9 years were tested with 1 TU RT 23 with Tween 80 in tuberculin testing centres specially set up in each village and the reactions were read between 48 & 72 hours after the test. The tuberculin testing/reading coverage was very high. Of 6702 eligible children, 5904 (97%) were tuberculin test read.

Individual reading assessment carried out at Ananthapur and Dharmapuri for the State Field Workers (SFWs) showed that agreement with Standard Reader (SR) of NTI at three induration levels i.e., 10+ mm, 14+ mm and 18+ mm were very high. The demarcation line between infected and uninfected appeared to be about 18 mm. In Ananthapur, the agreement at 18+ mm was 99% and at Dharmapuri it was 100% for SFW, and 98.4% for SFW-2. The estimates of prevalence rate of infection were 9.3% - SFW V/s 9.7% - SR at Anantapur, 5.2% - SFW V/s 5.2% - SR and 7.2% - SFW.2 V/s 7.2% - SR at Dharmapuri. The study further showed that it was possible to train general health workers, within a period of 3 months to attain a high level of efficiency. The general health services can successfully organise on their own a programme of tuberculin testing in the community with proper liaison and supervision by some nodal agency. The training and field supervision responsibilities may be shouldered initially by NTI or another suitable organisation, till these nodal agencies come up.

In a study of feasibility of treatment of smear positive patients with Short Course Chemotherapy (SCC) regimens under District TB Programme (DTP) conditions in a city, adverse drug reactions in terms of frequency of episodes, incidence in the cohort of patients, time of occurrence, major adverse reactions requiring modification of chemotherapy and or symptomatic treatment, were investigated.

Patients were allocated to one of the two 8 month SCC regimens i.e., Regimen 'A' 1 SHRZ/6TH, Regimen 'B' 2SHR/6TH. Overall incidence of adverse drug reaction in cohort of 265 patients was 37%, 9% of which were considered as major in nature. 34 episodes of such reactions resulted in modification of chemotherapy in 15 patients during intensive phase. Though gastro intestinal symptoms were predominant, cutaneous toxicity was the pre eminent cause of modification of regimen. No case of exfoliative dermatitis occurred. A total of 333 episodes of adverse drug reactions of minor nature occurred; 50% being gastro intestinal symptoms followed by cutaneous symptoms. More than 70% of all adverse drug reactions of intensive phase occurred in the first half of the period. There was no significant difference between the two regimens in the incidence of adverse drug reactions of either major or minor in nature.

SCC is being implemented in a phased manner in the DTP. Before introducing SCC in large number of districts, it would be prudent to find out whether SCC would be acceptable to both doctor and patient in terms of adverse drug reactions.
It can, therefore, be concluded that adverse reactions may not be a major constraint for inclusion of SCC under DTP for treating sputum positive tuberculosis patients provided that additional resources and man power are allocated to the DTCs to manage patients in the centre and extend effective guidance to staff working in peripheral centres.

Health is one of the basic rudiments for any activity in life. Efficiency in health care depends on its awareness among its users i.e., lay Persons,. While medical care, prophylaxis and prevention form one aspect of the disease, awareness of it among its users, their faith, belief and knowledge of the treatment given, are the other important factors which are often ignored. Even though 75% of the population in India are covered by health care and a significant contribution has been made in the last three to four decades in raising health status of the population, prevalence of communicable diseases and malnutrition still remain as major public health problems. This may be attributed to lack of health consciousness and health related factors such as social, economic, spiritual and environmental among lay persons, as important reasons in prevention of the disease. This paper briefly attempts to identify the lay persons by grouping them to literates/illiterates, determining their needs and wants, and its impact on health of the community. A review of the availability of health related information, their evaluation, selection and presentation using various communication media such as literature, press, audio visuals, posters and graphics is made. Finally, its acceptability by the lay persons at the grass root level has been discussed by presenting a case on the disease "Tuberculosis" and attempts made in this direction by the National Tuberculosis Institute, Bangalore.