GENEXPERT MTB/RIF

Presented by:

N.Ramalingam. M.A.,DCA., HE., “STOP TB Forum “District Secretary,“Master Trainer in SOFT SKILLS,TB/HIV,DM,LEPROSY etc. No.110,Kurinji Nagar, Velisemmandalam,Cuddalore -607001Tamil NaduMobile: 9443537619Email:ramalingam_n1953@yahoo.com

Advocacy efforts taken for

TB care and control

WHO estimates that only 66% of incident TB cases are detected.

This translates into 3 million NEW TB cases being missed every year.

Major efforts are needed to ensure all cases are detected, notified and treated.

In this connection:

1.Incresed use of new diagnostic is ensuring that significantly more TB patients are to be correctly diagnosed.

2.TB diagnostics and laboratory to be strengthening.

3.Laboratory confirmation of TB and Drug resistance is key to ensuring that individuals with TB signs and symptoms are correctly diagnosed and treated. In 2013, 58% of the 4.9 million Pulmonary TB patients notified Globally were bacteriologically confirmed via a WHO recommended test, including rapid tests such as Xpert MTB/RIF.

In late 2013 WHO expanded its recommendations on the use of Xpert MTB/RIF to include the diagnosis of TB in children and some forms Extra pulmonary TB.

By June 2014, 108 countries with access to Xpert MTB/RIF is concessional prices had started to use the technology, and more than one million text cartridge were being procured each quarter.

MY ADVOVACY APPROCHIn Tamil Nadu, such advanced diagnostic

instruments have been provided by the Tamil Nadu Govt. only few laboratories in the state and it is being supplied only where there is Medical Colleges districts.

In my Cuddalore District, there is no Medical Colleges.

So I taken up this issue as a challenge and must be got the machine to the District TB Centre, Govt. Head Quarters Hospital Cuddalore, since there is no Medical Collages and advocates for the same.

As a first step, I approached the Chief Minister of Tamil Nadu through Chief

Minister’s special cell , St.George Forte, Chennai with a request to supply ONE GENEXPERT MACHINE TO DISTRICT TB

CENTRE, GOVT. HEAD QUARTERS HOSPITAL, CUDDALORE, FOR THE BENFIT OF POOR PEOPLE LIVING IN CUDDALORE

DISTRICT.(Copy of letter enclosed).

Second step, I was approached through letter communication to Health Secretary,

Director of Medical & Rural Health services, Chennai, Director of Public Health and Preventive Medicine, Chennai, NRHM Director ,Chennai and all Medical & Health

Directors with a request to provide one GENEEXPERT MACHINE TO CUDDALORE

WITH REASANABLE JUSTIFICATIONS.

With my repeated requestations and representations to the Chief Minister of Tamil Nadu and higher authorities of Medical & Public Health officers in Tamil Nadu, my representation was accepted by Chief Minister of Tamil Nadu and sanctioning a Genexpert Machine to Cuddalore and it was installed at the Cuddalore District TB Centre Vide ref .No./20/DHS-RNTCP/2015 and it was informed me by email from Chief Ministers special cell office, Chennai.

The Joint Director of Medical and rural Health Services & FW , Cuddalore District was also informed me about the sanctioning of GENEXPERT Machine.

Advocacy Training is very well helping me to achieve the challenge.

SUMMARY

• AFTER ATTENDING ADVOCACY TRAINING AT CHENNAI I HAD ACHIEVED WITH

FERELESS AND ADVOCACY APPROCH AND GOT ONE GENEXPERT EQUIPMENT TO GOVT HEAD QUARTERS HOSPITAL , AT DISTRICT TB CENTRE, CUDDALORE ,

TAMIL NADU AND IT WILL BE INSTALLED AND START OPERATION DURING OCTOBER.

• ADVOCY TRAINING IS VERY USE FULL ME

AND VERY MUCH THANKS TO PTCC

ADVOCACY TRAINING AT CHENNAI

N.RAMALINGAM. MA., DCA., HE.,FACULTY-SOFT SKILL TRAININGDISTRICT SECRETARY,No.110, KURINJI NAGAR, VELISEMMANDALAM, CUDDALORE -607001Mobile9443537619 Email: ramalingam_n1953@yahoo.comThe Hon’ble Chief Minister of Tamil Nadu,Secretariat, Fort St. George, Chennai.Sir/Amma,

Sub: “STOP TB FORUM CUDDALORE DISTRICT” (Revised National Tuberculosis Control Programme) – GeneXpert Equipment supply requested to the District Head Quarters Hospital, Cuddalore-Requested- Regarding.

@@@I N.RAMALINGAM, DISTRICT SECRETARY OF “STOP TB FORUM CUDDALORE DISTRICT” is invited your kind

attention for consideration to provide GeneXpert equipment to detect and diagnose the TBHIV disease accurately, in Govt. Head Quarters Hospital, Cuddalore for the benefit of people living in Cuddalore district.

Extensive screening to detect TB among HIV infected and vice versa across the state under the Revised National Tuberculosis Control Programme(RNTCP) to contain the co-epidemic, has been taken up and the authorities have been equipped with eight GeneXpert equipments to accurately diagnose the disease. This will make significant development in facilitating early treatment.

Hitherto, such advanced diagnostic instruments have been provided by few laboratories only. Of the eight, three of these advances diagnostic equipments, which can detect TB among HIV persons within two hours, have been in Chennai including the Govt. Hospital of Thoracic Medicine (GHTM) in Tambaram Sanatorium. The remaining five equipments have been installed at Vellore, Namakkal, Trichi, Madurai and Tirunelveli.

I came to understand that the Govt. had taken up the screening to combat this biggest public health challenge in connection with the World TB Day-2015 (Observed annually on March 24)

As per official data, Tamil Nadu has reported 84,560 new TB cases in 2014 (out of 71,72,690 persons screened in the state) and of them 1145 were found to be MDR TB cases.

Now the focus is on prevention, control, treatment and relief of tuberculosis.

IN THIS CONNECTION I REQUESTED, THE HON’BLE CHIEF MINISTER OF TAMIL NADU TO PROVIDE ONE

GENEXPERT DEVICE TO THE GOVT. HEAD QUARTERS HOSPITAL, CUDDLORE FOR THE BENIFIT OF PEOPLE LIVING IN CUDDALORE DISTRICT WITH RELIEF OF TUBERCULOSIS.

Yours sincerely,(N.RAMALINGAM)Copy toThe Hon’ble Health Minister, Secretariat, Fort St.George Chennai.The Health Secretary, Secretariat, Fort St.George Chennai.The Director, Tamil Nadu Health System Project DMS, Complex, Chennai-6The Director, NRHM, DMS, Complex, Chennai-6The Director of Medical & Rural Health Services, DMS, Complex, Chennai-The Director of Public Health & Preventive Medicine, DMS, Complex,

Chennai-6The District Collector, Cuddalor District for information and necessary

further action.

GENEXPERT EQUIPMENT SACTIONED EMAIL LETTER FROM CHIEF MINISTER SPECIAL CELL TAMIL NADU

• cmcell@tn.gov.in• To• ramalingam_n1953@yahoo.com• Today at 5:38 PM• • Your Feedback - 2015/83086/EK what is the status of my existing petition?•

Reply from CMCELL – • • Accepted, The individual representation has been sent to the Additional Director of

Medical and Rural Health Services and State TB Officer,Chennai.6. Sanctioning a Gene Expert Machine to Cuddalore, by the above Directorate. Ii is installed at the Cuddalore District TB Center. Vide ref No: 20/DHS-RNTCP/2015 Dt: 25.06.2015

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•

FUTURE COURSE OF ACTION FOR TB CARE AND CONTROL

• "Find TB”.• “Treat TB”.• ”Working together to eliminate TB." • TB is still a life-threatening problem in the World,

despite the declining number of TB cases.• Anyone can get TB, and our current efforts to find and

treat latent TB infection and TB disease are not sufficient.

• Misdiagnosis of TB still exists and health care professionals often do not "think TB."

TO FIND TB…..

• Reach the missed cases• Appoint “ASHA’s” to detect symptomatic cases on TB

as Intensive case detection campaign at Door to Door steps followed by IEC in all Rural & Urban areas as Active Search.

• ASHA Should be appointed in all PHCs areas one ASHA for 1000 pop.

• ASHA’s should focuses on poor, vulnerable and marginalized groups and populations with limited or no access to control services.

• Intensive case detection campaign should be done in every 6 months once at the same areas.

• I am planning to adopt a Urban slum population in Cuddalore, about 10000 pop. for screening of TB systematic cases by Active Search by involving volunteers like NSS students, TB Forum Members and NGOs etc. during October2015 on wards

• Active Search may be planned once in every 6 months.

• Lab. Investigations may be done with Co-operation of Govt. RNTCP staff.

• Prior to Survey we are planned to conduct street corner play with a trained volunteers for creating awareness about TB and announcing that the survey to be conducted on the next day Morning.

• The symptomatic cases detected through active search referred for lab. Investigation to the nearest DMC.

• After diagnosing as TB we are arranged for providing DOTS through DOTS PROVIDER as DOTS (Directly Observed Treatment in Short Course) at their areas and followed them until completion of DOTS for 6 months.

• This process will be done for three years continuously.

• After three years may be declared as “NO TB AREA”

• This process May be Reached the ELEMINATION STATUS at the particular ADOPTED Urban Slum Area.

Thank You