End TB -2025 - Amrita Institute as the pioneer
Weekend Special

End TB -2025 - Amrita Institute as the pioneer

Government of India declared the target of eliminating TB in 2025 far ahead of global target. The challenges for eliminating TB are the diagnostic delay, long duration of treatment, drug interaction, pill burden and drug resistance. It is also to be remembered that more than 60% TB patients are being treated in private sectors. This may include small hospitals, big tertiary care hospitals, single doctor clinics, etc. Standardising diagnostic and treatment modality is a big challenge in these aspects.

In 2014, Govt of India and Revised National TB Control Program(RNTCP) came forward with standards of TB care in India (STCI)

The biggest challenge for TB control especially in private sector was lack of estimate of TB burden. In 2012, Govt. of India declared tuberculosis as a notifiable disease. In 2018, Govt. of India amended the notification with provision of punishment, if failing to notify by treating physician or chemist, as per Article 269 and 270.

Amrita Institute of Medical Sciences, Kochi is one of the first institutes in the country, which ensured 100% TB notification.

Amrita initiated an innovative social movement called as ‘TB Free Kochi’ with District TB authorities and IMA. Amrita also paved way to the formation of ‘End TB Consortium’ which involved major private hospitals in Ernakulum district. As part of the programme, the institute organised active screening in orphanages, migrant workers and slums. It was a part of advocacy and social mobilisation towards TB free India.

Anti-tuberculosis treatment stewardship programme is a novel administrative strategy in ensuring standards in diagnosis and management of Tuberculosis based on universally accepted guidelines. With a nodal centre for Pharmacovigilance activity at Amrita, adverse events related to Anti TB treatment and Management of TB with comorbidities are also ensured by means of Anti TB Stewardship programme.

Another important aspect is dealing with airborne infection control practices. Frequent awareness sessions and periodic assessment of Infection control practices and facility along with Health care screening are being done and Screening for TB in health care workers also done.

Amrita Institute conducted several continuous medical education programme for disseminating newer guidelines and to form newer strategies in TB Control.

Newer rapid diagnostic modality like molecular methods {Cartridge base Nucleic acid amplification test (CB NAAT)} detects DNA material of organism within 2 hours and also give status of Rifampicin resistance. By means of this test, early diagnosis and Rifampicin susceptibility is identified in the institution. Universal Drug Susceptibility Test (DST) is an approved policy by RNTCP now and Amrita is already practising Universal DST and equipped with Liquid AFB Culture methods and first line Drug susceptibility test. RNTCP unit in Amrita is providing Free drug and referral services as per patient’s wish.

Proper follow up and adherence monitoring is also an important strategy in ensuring optimal care. RNTCP started a private ATT register and is providing after sales services for all the notified patients.

A dream always leads us to put an effort. Everybody should be the leader for a TB Free world to achieve TB elimination.

Dr. Akhilesh. K, Associate Professor

Department of Pulmonary Medicine

Amrita Institute of Medical Sciences & Research Centre, Kochi, Kerala