NATIONAL TUBERCULOSIS INSTITUTE
National Tuberculosis Institute (NTI), Bangalore is an organisation under the Directorate General of Health Services, Ministry of Health and Family Welfare, established in 1959 in close collaboration with the World Health Organization (WHO) and UNICEF. This is a premier Institute in the field of Tuberculosis control in South East Asia, which caters to the human resource needs for TB control in the region. Since 1985, the Institute has been functioning as a WHO Collaborative Centre for Training and Research. The Institute is also involved in carrying out Operational Research on various components of TB Control, mainly carried out by the Epidemiology and Control Sections. The Bacteriological Wing of the Institute has been recognised as a National Reference Laboratory for External Quality Assessment in the TB Control activity. It also assists in establishing Intermediate Reference Laboratory for Culture and Drug Sensitivity tests, across the country.
The Institute has also been identified as the nodal centre for operational research related to RNTCP. The major activities as a nodal centre is to organise workshops, prepare the research agenda and dissemination of research data through publications.
Recently the Institute has been re-organised with formation of Divisions /Units the details are given below:
Some of the important activities carried out by Divisions/Units is given below:
HRD and Documentation Division
The Institute has pioneered in the field of Human Resources Development. It is involved in conducting the following training programmes to the TB Programme Managers positioned at different parts of the country.
1. RNTCP & TB-HIV Modular training Programme are conducted at NTI where STDCs, STOs, DTOs, MO-TCs and faculty of Medical Colleges participated.
2. Managing Information for Action (MIFA) Training .
3. Training in Preventive maintenance and minor repairs of Binocular Microscopes.
4. EPI Centre Training Workshop.
5. Workshop for Microbiologist for updating training material guidelines for National Reference Laboratories.
6. SAARC Regional Training of Microbiologist on Culture & DST of MTB.
7. TB Operational Research Workshop.
8. PCR based LPA Training.
9. Orientation programme of one day duration were organized for about 1181 undergraduate Medical, Microbiology and Nursing and Pharmacy students sponsored by different Institute across the country.
10. External Quality Assessment (EQA) has been given importance under RNTCP in the recent years. Training on the procedures of EQA was imparted to the Laboratory personnel of different parts of the country. Training in Culture & DST / Smear Microscopy are imparted to Microbiologists/Lab technicians.
11. Publication Activities: The faculty of the Institute publish research papers in the leading journals on TB. Make Presentations and Poster sessions on the basis of the research studies conducted by the institute in the National Conference on TB and Chest Disease.
The in-house publications of NTI Bulletin are undertaken.
12. As a large number of people are trained at various levels, however the details of the people trained are not available. Therefore, it is proposed to have a TB trained Manpower data base of the country at NTI
1. Operationalise the EQA for sputum smear microscopy network in the states in conjunction with /STDCs or IRLSs. Carry out NRL responsibilities of EQA such as Onsite Evaluation (OSE). Panel testing (proficiency testing of lab staff) to ten states at least once in a year for 3-4 days (including one to two districts visits), and make visits as and when required depending on the priorities /necessity to improve and help the performance of labs. Eight. Prepared slides are used for panel testing during the visits.
2. Conducting quality improvement workshops for the state level programme managers with a view to find solutions to EQA related operational and technical problems faced in the field.
3. To implement and verify Random Blinded Rechecking (RBRC) producers and improve the performance of labs based on analysis of the RBRC data in conjunction with STDCs.
4. Capacity building and strengthening the ten state level TB laboratories (STDCs) with respect to proficiency in culture and Drug Susceptibly Testing including second line drugs.
5. Conducting Anti-TB Drug résistance surveillances of priority states involving processing of representative sample of the states to obtain information of prevalence of drug resistance, with a view to support logistics of DOTS – Plus programme under expansion of DOTS and RNTCP and conduct/participate in National Level disease prevalence studies/surveys.
6. The Lab team of the Institute carryout on site evaluation of STDC laboratories of different states and provides necessary guidelines to establish quality laboratory to undertake EQA and DRS studies.
7. Carry out Lab based research studies using modern diagnostic techniques and tools viz., Gene expert, Genetic Analyzer, HPLC for NTMs, LPA and MGIT 960
Upgradation of Infrastructure
On a proposal submitted by FIND on behalf of UNIT AID the Govt. of India decided to establish an International Centre for Excellence in Laboratory Training (ICELT) at the National Tuberculosis Institute, Bangalore with the following Vision and Mission.
Vision: Establish a state of the art teaching and training facility for imparting quality laboratory practices for tuberculosis and other opportunistic infections and promote a healthier India and Asia.
Mission: To support the scaling up of laboratory capacity building in India and Asia by providing hands-on training courses in the diagnosis and monitoring of major infectious diseases such as TB, HIV/AIDS and Malaria.
International Centre for Excellence in Laboratory Training (ICELT) will provide Training to the personnel who are working in about 43 Culture Laboratories in different parts of the Country in Newer Diagnostic Tools for Diagnosing TB & Drug resistant TB. The ICELT was inaugurated on 20th January 2011.
Epidemiology and Research Division
The research studies/projects taken up by the institute are as follows:
Activities that are planned to be carried out:
i) Multi centric studies on (a) capture – recapture studies to estimate the incidence of TB, (b) TB diagnosis and treatment practices of providers in the private sector and public sector other than public health sector (c) uptake and barriers for HIV testing, ART and CPT among TB cases diagnosed under RNTCP (d) study on relapse and mortality in RNTCP:
Monitoring & Evaluation Division
With full coverage of RNTCP in the country, the Institute is not compiling the reports on NTP. At present, the monitoring activity is being carried out by the Central TB Division under DGHS.
The activities that are planned to be carried out are:
ii) Web based Operational Research Registry System for monitoring OR activities
iii) Development of National TB Register
iv) Model DOTS area development
v) To have individual patient wise monitoring using modern technology demonstrated by hand held based mobile data management system.
Communication and Sociology Division
1. The Scientific Gallery has been established to disseminate the general information on TB the evolution of the programme and achievements of the Institute since its inception. Considering the needs of various categories of trainees, two methods of display units viz., Photo Display and Projection facility and Information Kiosk are available.
2. One day Awareness Programmes are held by the Division for the Medical and Para medical students from different institutions of the state and neighbouring states, orientation to students of medical colleges and other teaching.
3. The Division is planning to carryout research on sociological aspects of TB.
1. The administrative division facilitates for the comfortable stay of the participants who come for Training /Workshops/Seminars by taking care of there accommodation by proper upkeeping of Hostels and Guest Houses.
2. It also takes care of the Transport requirements for the Operations research and Field visits of Trainees.
3. It is also responsible for security, upkeeping and proper ambience of 23 acres of the sprawling NTI campus.
Other important Activity
1. The Faculty and the technical staff participated in the appraisal and Central Evaluation of RNTCP districts as and when called upon to do so and given the technical support for implementation of RNTCP.