In this video we will be talking about RNTCP & DOTS….we will cover the drugs in another part 2 video…..Our videos are solely based on PARK Textbook of community medicine…..
RNTCP stands for Revised national TB control programme…as you must be already knowing RNTCP deals with TB…So let us deal TB with more detail….TB is considered to be the barometer of social welfare….which means you can assess the success of the social welfare schemes of a country by the prevalence of TB in that country….The world TB Day is celebrated on 24th March… TB is the most common opportunistic infection for HIV in india…The National TB Institute is located in Bangalore & TB Research Centre is in Chennai… As you must be already knowing TB is caused by Mycobacterium Tuberculosis….This bacillus was discovered by Robert Koch & it is alcohol & acid fast….it is stained by Ziehl Neelson Stain….generation time of TB bacillus is 20 hours….TB bacterium remains alive in sputum for 1 day & in droplet nuclei for 10 days…An interesting fact you can note is that without treatment 50% of TB infected patients will die….25% of the patients will develop chronic infections & 25% will remain healthy….. Did you know that every TB sputum positive patient can infect upto 10 to 15 individuals in a year !!!!!….
Next you should know about something called annual risk of infection in relation to TB…it stands for the proportion of the population that will be infected with TB in the course of 1 year….it tells about the incidence of TB infection & is also known as Tuberculin Conversion Index…it is the best indicator to tell about the magnitude of the problem of TB in a population..in India ARI is 1.7 %......for every 1 % rise of ARI….50 smear sensitive cases will be detected per lac population….another thing… I told you about the incidence of TB infection….what about the prevalence of TB infection in India…? How do you measure that… You measure that by the Standard Tuberculin test….& the prevalence in India is 40%
Next some details about the staining properties of TB bacillus….as told earlier TB is stained by ZN stain…& 25 % sulphuric acid is used as decolourizer…The minimum bacillary load needed for positive result is 10,000 bacilli per ML of sputum…This is the standard examination protocol for TB…if no bacilli are seen in 100 oil immersion fields then the result is considered to be negative…. if 1 to 9 bacilli are seen in 100 oil immersion fields then the result is considered to be scanty…. if 10 to 99 bacilli are seen in 100 oil immersion fields then the result is considered to be + 1…. If 1 to 10 bacilli are seen per oil immersion field then consider it as +2…….finally If more than 10 bacilli are seen per oil immersion field then consider it as +3…
Next you must be wondering why RNTCP starts with revised….what was revised & why?.....actually earlier the programme was called Nation TB programme ….which was subsequently changed to Revised National Tuberculosis control programme…so what were the changes that were brought in by the RNTCP ?? ….first difference was the objective,… National TB Programme had the objective of early diagnosis & treatment of all TB cases in India….but this was practically very difficult to achieve… RNTCP on the other hand had a much more realistic objective…It aimed in successfully detecting 90% of all incident TB cases….& successfully treating 90% of all new smear positive & 85% of all previously treated cases…that is the relapse & recurrence cases..RNTCP was based on the DOTS strategy…we will deal with DOTS a while later…also..NTP was more based on Chest xrays while RNTCP was based on microscopy………….
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