Module 1-4 - Managing the Revised National Tuberculosis...

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Managing the Revised National Tuberculosis Control Programme in your area A Training Course Central TB Division Directorate General of Health Services, Ministry of Health and Family Welfare Nirman Bhavan, New Delhi 110011 y Course Introduction y Ensuring Identification of Tuberculosis Suspects y Supporting Laboratory Services y Administering Treatment Modules 1- 4
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Managing the Revised National Tuberculosis Control Programme in your area A Training Course April 2005 Central TB Division Directorate General of Health Services, Ministry of Health and Family Welfare Nirman Bhavan, New Delhi 110011 y Course Introduction y Ensuring Identification of Tuberculosis Suspects y Supporting Laboratory Services y Administering Treatment Modules 1- 4
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Contents MODULE 1: COURSE INTRODUCTION. ....................................................................... 1 PURPOSE OF THE TRAINING COURSE . ................................................................. 1 EXTENT OF THE TUBERCULOSIS PROBLEM . ....................................................... 3 OBJECTIVES OF THE REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP). ............................................................................................ 5 STRUCTURE OF THE REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME . ........................................................................................................... 7 National level (Central TB Division). ......................................................................... 8 State level . ............................................................................................................... 8 District level. ............................................................................................................. 8 Sub-district level (Tuberculosis Unit level). ............................................................... 9 Peripheral Health Institutions (PHIs) . ..................................................................... 10 STRUCTURE OF EXERCISES OF THE TRAINING MODULES. ............................. 12 DEFINITIONS: THE REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME . ......................................................................................................... 14 MODULE 2: ENSURING IDENTIFICATION OF TUBERCULOSIS SUSPECTS. ......... 17 INTRODUCTION. ...................................................................................................... 17 PROCESS OF DIAGNOSIS. ..................................................................................... 18 DIAGNOSTIC ALGORITHM FOR PULMONARY TB . .............................................. 20 IMPORTANCE OF PROPERLY IDENTIFYING TB SUSPECTS . ............................. 21 COLLECTING SPUTUM FROM TUBERCULOSIS SUSPECTS . ............................. 25 Guidelines for collecting sputum . ........................................................................... 25 Tasks performed before sputum collection. ........................................................ 26 Tasks performed during sputum collection. ........................................................ 29 Tasks performed after sputum collection. ........................................................... 30 TRANSPORT OF SPUTUM SPECIMENS . ............................................................... 30 EXERCISE WORKBOOK E1: LABORATORY FORM FOR SPUTUM EXAMINATION . ........................................................................................................ 35 MODULE 3: SUPPORTING LABORATORY SERVICES. ............................................ 39 INTRODUCTION. ...................................................................................................... 41 MONITOR DOCUMENTATION RELATED TO MICROSCOPY EXAMINATIONS . ..41 ZIEHL–NEELSEN STAINING PROCEDURE . .......................................................... 43 TUBERCULOSIS LABORATORY REGISTER. ........................................................ 45 Using the Tuberculosis Laboratory Register . ......................................................... 47 Check the accuracy of the Tuberculosis Laboratory Register . ............................... 47 Monthly summary. .................................................................................................. 48
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Follow-up sputum smear examinations. ................................................................. 53 QUALITY ASSURANCE (QA) FOR SMEAR MICROSCOPY. .................................. 60 External Quality Assessment (EQA) . .................................................................... 60 On-site evaluation of Designated Microscopy Centres. .......................................... 60 Random Blinded Rechecking of Routine Slides. .................................................... 61 MAINTAIN AN ADEQUATE SUPPLY OF REAGENTS AND OTHER MATERIALS64 ENSURE THAT CONTAMINATED MATERIALS ARE DISPOSED OF SAFELY . ...68 CONDUCT VISITS TO DESIGNATED MICROSCOPY CENTRES . ......................... 69 CHECKLIST FOR LABORATORY SUPERVISION. ................................................. 70 MODULE 4: ADMINISTERING TREATMENT. ............................................................. 77 INTRODUCTION. ...................................................................................................... 77 TUBERCULOSIS TREATMENT CARD. ................................................................... 79 Complete Tuberculosis Treatment Cards . ........................................................ 80 Record general patient information. ................................................................. 81 Record disease classification. .......................................................................... 82 Record type of patient. ..................................................................................... 84 Record results of pretreatment sputum smear examinations of patients who will begin treatment for tuberculosis. ...................................................................... 85 Record the patient’s weight. ............................................................................. 86 Record history of previous anti TB treatment. .................................................. 86 Determine the category of treatment. ............................................................... 86 Treatment Regimens . ...................................................................................... 88
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Module 1-4 - Managing the Revised National Tuberculosis...

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