The practice of three
sputum smear examinations as a primary diagnostic tool for pulmonary
TB should be promoted and established. All departments of the medical
colleges should be sensitized to the programme, and activities within
the hospital co-ordinated to ensure that each and every adult outpatient
is asked about cough, and that all persons with cough for 3 weeks
or more undergo 3 sputum examinations at the designated laboratory.
This should be widely publicized throughout all OPDs of the medical
colleges through posters, etc.
of the RNTCP is based on a sound technical rationale and should
be followed as a standardized means of diagnosing TB patients.
RNTCP regimens are
effective when categorization of patients is made accurately as
per guidelines and direct observation of treatment is ensured. The
treatment practices followed in medical colleges should thus be
standardized to conform to RNTCP principles and guidelines.
regimens should be directly observed in the intensive phase.
Procedures for referring
patients from hospitals to peripheral facilities should be strengthened.
A directory providing information of RNTCP facilities within the
district should be made available by each DTO to the designated
authority of every medical college in the area in order to facilitate
appropriate referrals of patients. The hospital should assign one
person with the responsibility for ensuring effective referral and
for tracking the effectiveness of the referral process in close
co-ordination with the District/State TB officials. Peripheral facilities
are responsible for providing feedback information to the hospital
and ensuring that patients referred by the hospital receive appropriate
and complete treatment.
|| For management
of TB patients, the following should be considered:
ill TB outpatients who do not reside in the catchment area
of the hospital should not be initiated on treatment but referred
to the DOT centre nearest to the residence of the patient.
Except in emergency
cases or in seriously ill patients, rifampicin-containing
regimens should not be used if direct observation of treatment
cannot be ensured.
prescribed to admitted patients should, as far as possible,
conform to the accepted protocols.
of the treatment regimen initiated, all patients should receive
directly observed treatment during their period of admission
in the hospital.
||Supply of drugs
in all DTCs & DOT Centers must be ensure.