Transcript Status of RNTCP in Gujarat

Status of RNTCP in Gujarat
Dr. PV Dave
State TB Officer
Gujarat
2nd Quarter 2013
What is Tuberculosis ?
• Tuberculosis (TB) is a highly infectious bacterial
disease caused by Mycobacterium tuberculosis.
TB can affect any part of the body. When it affects
the lungs it is called pulmonary TB. The
commonest form of TB is pulmonary TB. TB in any
other part of the body (i.e. other than lungs) is
called extra pulmonary TB.
India is the highest TB burden country accounting
more than one fifth of the global incidence
Global annual incidence = 9.23 million
India annual incidence = 1.96 million
India is 17th among 22 High Burden
Countries (in terms of TB incidence rate)
India (21%)
Other countries (20%)
Other 13 HBCs (16%)
China (14%)
Phillipines (3%)
Indonesia (6%)
Pakistan (3%)
Nigeria (5%)
Ethiopia (3%)
Bangladesh (4%)
South Africa (5%)
Source: WHO Geneva; WHO Report 2009: Global Tuberculosis Control; Surveillance, Planning and Financing
HEALTH IN THE MILLENNIUM DEVELOPMENT GOALS
Goal 6: Combat HIV/AIDS, malaria and other diseases
• Target 6c: Halt and begin to reverse the incidence of malaria and other
major diseases including TB.
• Indicator 6.9: Incidence, prevalence and death rates associated with TB
• Indicator 6.10: Proportion of TB cases detected and cured under DOTS
Stop TB Partnership targets
• By 2005: At least 70% of people with sputum smear-positive TB will be
diagnosed (i.e. under the DOTS strategy), and at least 85% successfully
treated. The targets of a case detection rate of at least 70% and a
treatment success rate of at least 85% were first set by the World Health
Assembly of WHO in 1991.
• By 2015: The global burden of TB (per capita prevalence and death rates)
will be reduced by 50% relative to 1990 levels.
• By 2050: The global incidence of active TB will be less than 1 case per
million population per year.
RNTCP – Goal and Objectives
• Goal
– The goal of TB control Programme is to decrease
mortality and morbidity due to TB and cut
transmission of infection until TB ceases to be a
major public health problem in India.
• Objectives:
– To achieve and maintain a case detection of at least
70% of new sputum positive TB patients
– To achieve and maintain a cure rate of at least 85%
in such patients
Directly Observed Treatment, Short-course
(DOTS) – a five point strategy


Political and Administrative
commitment
Good Quality Diagnosis by Sputum
smear microscopy

Uninterrupted supply of good quality drugs

Directly observed treatment (DOT)

Systematic monitoring and
accountability
TB Register
Note: Directly Observed Treatment (DOT) is only one of the five components of DOTS strategy
Annual Risk of TB Infection (ARTI) - 1
• One of the key epidemiological indicators of the tuberculosis
situation in a community
• It represents the proportion of population that gets newly
infected (or re-infected) with tubercle bacilli over the course of
one year.
• Currently the average ARTI in the country as a whole is
estimated to be 1.5%.
Annual Risk of TB Infection (ARTI) - 2
• It has been estimated that for every one percent annual risk of
tuberculosis infection, there are about
– 50 new pulmonary sputum smear positive (NSP) cases
– 50 new pulmonary sputum smear negative (NSN) cases
– 25 re-treatment pulmonary cases
– 10 extra-pulmonary cases
– Totaling to 135 cases
…………..per 100,000 population per year.
• This means that, with an ARTI of 1.6% for West Zone
(including Gujarat), there will be
– 80 new smear positive cases,
– 80 new smear-negative cases,
– 40 re-treatment cases, and
– 16 extra-pulmonary cases,
– totaling to 216 cases
……………per 100,000 population per year.
Estimated* Incidence of TB in India
(No. of NSP Cases per 100,000 population, per
year)
* Estimated from ARTI survey
North
West
East
South
National
75
North Zone
95
East Zone
65**
West Zone
80
South Zone
50**
** For programme monitoring
purpose estimated cases in East &
South zones have been kept at the
national level of 75
Structure of RNTCP
Central TB Division,
DGHS, New Delhi
Designated IRL and
DOTS-Plus site
Nodal point for
TB control
DDG-TB, CMO-TB
STO, Deputy STO,
MO, Accountant, ,IEC Officer,
State TB Cell
District TB
Centre
TB-HIV Coordinator, SA, DEO
DTO, MO-DTC,
LT, DEO, Driver
Urban TB Coordinators,
Communication Facilitator
One/ 5 lakh (2.5 lakh in
hilly/ difficult/ tribal area)
One/ lakh (0.5 lakh in
hilly/ difficult/ tribal
area)
TBHV
Tuberculosis
Unit
Designated
Microscopy Centre
MO-TC
STS, STLS
MO, LT
DOT Provider – MPW,
NGO, PP, Community Volunteer
DOT Centre
RNTCP Infrastructure in Gujarat
State TB Cell, Gandhinagar
1
State TB Training & Demonstration Centre /
Intermediate Reference Laboratory - Ahmedabad
1
District TB Centers (reporting units)
30
TB Units
144
Designated Microscopy Centers
749
Peripheral Health Institutes (PHIs)
1940
DOTS providers
43618
Human Resource – State level, 2nd Quarter 2013
Name of the post
STO
Number
sanctioned
Number in
Place
Percentage in
Place & trained
1
1
100%
1(regular)
1
100%
STDC Director
1
1
100%
Assistant Program
Officer/Epidemiologist
1
0
NA
TB –HIV coordinator
1
1
100%
IEC officer
1
1
100%
State Accountant
2
2
100%
State DEO
2
2
100%
IRL Microbiologist
1
1
100%
Urban TB –
Coordinators
1
1
100%
DEO (IRL)
1
1
100%
Sr LT - IRL
1
1
100%
Statistician *
1
1
100%
Statistical Assistant *
3
3
Medical Officer STC
* STC+STDC
100%
Other Human Resource in the state under TB cadre
Name of the post
Level *
Number
sanctioned
Number
(%) in
Place
State TB Cell
3
3
100.00
Research Officer
STDC
1
0
NA
Research
Assistant
STDC
1
0
Statistical
Assistant
STDC
Computer
STDC
2
1
100.00
TB Supervisor
STDC
3
1
100.00
Treatment
Organizer
District TB
Centre/ADTC
9
9
TB Supervisor
District TB
Centre/ADTC
66
Statistical
Assistant
District TB
Centre/ADTC
23
Health Visitor
District TB
Centre/ADTC
28
TB Supervisor
Percentage in place &
trained
NA
1
0
NA
100.00
57
100.00
14
100.00
15
100.00
* Level: STC/ STDC/DTC/ADTC/periphery
Achievements at a Glance
2nd Quarter 2013
•
•
•
•
•
•
•
•
Gujarat state has been in the target zone, consecutively since last more than
Seven Years
26 / 30 (87%) reporting units are in the target zone
113/143 (79%) TUs in target zone
TB Suspects Examined – 2Q13
: 1,06,668
New Smear Positive Case Detection Rate – 2Q13
: 75%
New Smear Positive Cure Rate – 2Q12
: 86%
Total TB patients put on treatment
: 18,864
New Smear Positive Cases put on treatment
: 9334
Since the inception of RNTCP up to 30-6-13
– Total TB suspect Examined
– Total TB Patients put on DOTS treatment,
– New Smear Positive patients put on treatment
– Additional lives saved
– Identification of MDR TB Suspects
– Diagnosis of MDR TB Cases
– MDR TB Cases Put on CAT – IV
– XDR TB Cases Put on CAT – V
: 45,56,096
: 9,69,093
: 4,15,995
: 1,74,437
: 38,421
: 5,301
: 4,173
: 56
Annualized New Smear Positive Case Detection Rate and
Annualized New Smear Positive Case Detection Rate and Treatment
Treatment Success Rate in DOTS areas of Gujarat, 2000-2Q13
Success Rate in DOTS areas of Gujarat, 2000-2Q13
100%
90%
80%
70%
60%
40%
1st Q 00
2nd Q 00
3rd Q 00
4th Q 00
1st Q 01
2nd Q 01
3rd Q 01
4th Q 01
1st Q 02
2nd Q 02
3rd Q 02
4th Q 02
1st Q 03
2nd Q 03
3rd Q 03
4th Q 03
1st Q 04
2nd Q 04
3rd Q 04
4th Q 04
1st Q 05
2nd Q 05
3rd Q 05
4th Q 05
1st Q 06
2nd Q 06
3rd Q 06
4th Q 06
1st Q 07
2nd Q 07
3rd Q 07
4th Q 07
1st Q 08
2nd Q 08
3rd Q 08
4th Q 08
1st Q 09
2nd Q 09
3rd Q 09
4th Q 09
1st Q 10
2nd Q 10
3rd Q 10
4th Q 10
1st Q 11
2nd Q 11
3rd Q 11
4th Q 11
1st Q 12
2nd Q 12
3rd Q 12
4th Q 12
1st Q 13
2nd Q 13
50%
Annualised New S+ve CDR
Success rate
Linear (Annualised New S+ve CDR)
•Population projected from 2001 census
•Estimated no. of NSP cases - 80/100,000 population per year (based on recent ARTI report)
SuccessSuccess
Rate Rate
Vs Case
Detection Rate (2Q12/2Q13)
Vs Case Detection Rate (2Q12/2Q13)
HIGH SUCCESS LOW DETECTION
HIGH SUCCESS HIGH DETECTION
94
TARGET ZONE
Ahmedabad (R), Banaskantha,
Junagadh, Kachchh, Mehsana
Bhavnagar
Anand
Dangs
Success Rate (%)
88
Rajkot
Navsari
Gujarat
Jamnagar
G'nagar,
Sabarkantha
Porbandar
VMC,Valsad
85
Narmada
Dahod
91
Amreli
Kheda
Vyara
Bharuch
Vadodara (R)
Surat-R
Panchmahals (G)
Chhotaudepur
Patan
Srt Muni. Corp
82
S'nagar
79
76
A'bd Muni. Corp.
LOW SUCCESS LOW DETECTION
LOW SUCCESS HIGH DETECTION
73
60
65
70
75
80
Case Detection Rate (%)
85
90
95
100
2nd Quarter 2011
TB Suspects Examined per
lac per quarter
BAN AS KAN TH A
PATAN
KAC HCHH
MAHESANA
SAB AR KAN TH A
2nd Quarter 2013
GANDH INAGAR
PA NCH
MA HALS
AMC
KHEDA
SURENDR ANAGAR
DAHOD
AHMED ABAD
Expected : 150 / Lac / Qtr
VAD ODAR A
ANA ND
JAMNAGAR
CHHOTA
UDEP UR
VMC
RAJKOT
AR
ND
NARMADA
BA
R
PO
TB Susp ect
Exam ined Pe r La c
< 10 0
100 - 149 .9
>= 15 0
BHARUCH
BHA VNAGAR
AMRELI
SURAT
JUNAGADH
VYARA
SMC
THE
DANGS
NAV SA RI
BAN AS KAN TH A
VALS AD
Gujarat: 162
PATAN
KAC HCHH
MAHESANA
SAB AR KAN TH A
2nd Quarter 2012
GANDH INAGAR
PA NCH
MA HALS
AMC
SURENDR ANAGAR
KHEDA
DAHOD
BAN AS KAN TH A
AHMED ABAD
VAD ODAR A
ANA ND
PATAN
KAC HCHH
MAHESANA
JAMNAGAR
SAB AR KAN TH A
CHHOTA
UDEP UR
VMC
RAJKOT
GANDH INAGAR
KHEDA
SURENDR ANAGAR
AR
ND
DAHOD
AHMED ABAD
VAD ODAR A
ANA ND
JAMNAGAR
CHHOTA
UDEP UR
VMC
NARMADA
TB Susp ect
Exam ined Pe r La c
< 10 0
100 - 149 .9
> 15 0
BHARUCH
BA
R
PO
PA NCH
MA HALS
AMC
BHA VNAGAR
AMRELI
JUNAGADH
SURAT
SMC
VYARA
RAJKOT
AR
ND
NARMADA
BA
R
PO
TB Suspect
Examined Per Lac
< 100
100 - 149.9
>= 150
BHARUCH
NAV SA RI
BHA VNAGAR
AMRELI
JUNAGADH
SURAT
SMC
VYARA
NAV SA RI
VALS AD
Gujarat: 159
VALS AD
THE
DANGS
Gujarat: 171
THE
DANGS
TB Suspects Examined
per lakh per
quarter
Expected : 150 / Lac / Qtr
Dhanera
Khedbrahma
Deesa
Palanpur
Vav
Danta
Rann of Kachchh
Patan
Radhanpur
Bhiloda
Visnagar
Mehs ana
_DT C
Nak htrana
Himat
nagar Dhan
Ma nsa
Bhac hau
Kadi
Anjar
Viram
gam
Dhr angadhra
Mandv i
Morbi
Jamnagar_D TC
Bavla Matar
Balas
inor
Nadiad
Sarsa
Kham
bhat
DT C_Rural
An kla v
Santram
pur
Lalpur
Godhra
Savli
Halol
Baroda
B aw ch a w a d
Bh aruch
Shihor
Porbandar
Valia
Ju nag adh
TB S usp ect
Ex am ined P er L ac
< 100
100 - 14 9.9
>= 15 0
No D ata
Kavant
Rajpipla
Babr a
Junagadh
_Urba n
_R ural
Amreli
_DT C
Palitana
Sa va r
ku ndla
Mangr ol
Mandavee
Kamrej
Vyara
Rajula
Una
Songadh
Nav sari
Vansda Ahwa
Gandevi
Chikhli
Valsad
Pardi
Gujarat: 171
Nizar
Bardoli
Su ra t
Veraval
Dediapada
Hansot
Talaja
Keshod
CU P
Pavi_
Sank Jetpur
Padr a
Jetpur
Upleta
D'baria Garbada
Dhanpur
Go tri Ju b ili b a u gheda
Amod
Botad
Kotda S hangani
Bhilad
Jhalod
kh eda Dahod
Dhandhuka
Kham bhalia
Fatehp ura
Shahera
Mora Lim
Atars
umba
Petlad
Muli
Dhr ol
Meghraj
sura
G'nagar
_DT C Dahe
gam
Surendr a
nagar
#
2nd Quarter 2013
Idar
Kheralu
Cha na sma
Rapar
Bhuj_DT C
TB Units – Gujarat
Diodar
Dharam pur
Kapr ada
2Q 2011
NSP Case Detection Rate
BAN AS KAN TH A
PATAN
KAC HCHH
MAHESANA
SAB AR KAN TH A
2Q 2013
GANDH INAGAR
PA NCH
MA HALS
AMC
KHEDA
SURENDR ANAGAR
DAHOD
AHMED ABAD
Expected : 70%
VAD ODAR A
ANA ND
JAMNAGAR
CHHOTA
UDEP UR
VMC
RAJKOT
AR
ND
NARMADA
BA
R
PO
BHARUCH
NS P Cas e Detection Rate
< 59.5%
59.51% - 69.5%
> 69.5%
BHA VNAGAR
AMRELI
SURAT
JUNAGADH
BAN AS KAN TH A
VYARA
SMC
THE
DANGS
NAV SA RI
VALS AD
PATAN
KAC HCHH
MAHESANA
Gujarat State: 77%
SAB AR KAN TH A
GANDH INAGAR
2Q 2012
PA NCH
MA HALS
AMC
KHEDA
SURENDR ANAGAR
DAHOD
AHMED ABAD
VAD ODAR A
ANA ND
BAN AS KAN TH A
JAMNAGAR
CHHOTA
UDEP UR
VMC
RAJKOT
PATAN
MAHESANA
SAB AR KAN TH A
GANDH INAGAR
PA NCH
MA HALS
AMC
SURENDR ANAGAR
KHEDA
DAHOD
AHMED ABAD
VAD ODAR A
ANA ND
JAMNAGAR
NARMADA
AR
ND
A
B
R
PO
KAC HCHH
NS P Cas e Detection Rate
< 59.5%
59.51% - 69.5%
> 69.5%
BHARUCH
BHA VNAGAR
AMRELI
JUNAGADH
SURAT
SMC
VYARA
CHHOTA
UDEP UR
VMC
RAJKOT
AR
ND
NARMADA
BA
R
PO
NS P Cas e Detection Rate
< 59.5%
59.51% - 69.5%
> 69.5%
NAV SA RI
BHARUCH
THE
DANGS
BHA VNAGAR
AMRELI
JUNAGADH
SURAT
SMC
VYARA
NAV SA RI
VALS AD
THE
DANGS
VALS AD
Gujarat State: 75%
Gujarat: 75%
NSP Case Detection Rate
Expected : 70%
TB Units – Gujarat
Dhanera
2nd Quarter 2013
Khedbrahma
Deesa
Palanpur
Vav
Danta
Rann of Kachchh
Diodar
Patan
Radhanpur
Himat
nagar Dhan
Ma nsa
Nak htrana
Bhac hau
Kadi
Anjar
Viram
gam
Dhr angadhra
Mandv i
Morbi
Jamnagar_D TC
Bhiloda
Visnagar
Mehs ana
_DT C
Rapar
Bhuj_DT C
Idar
Kheralu
Cha na sma
Bavla Matar
Balas
inor
Nadiad
Sarsa
Kham
bhat
DT C_Rural
An kla v
Santram
pur
Lalpur
Godhra
Savli
Halol
Baroda
B aw ch a w a d
Babr a
Bh aruch
Shihor
Valia
Ju nag adh
NSP C as e Det ec tion Rat e
< 59. 5%
59.5 1% - 69 .5%
>6 9.5 %
No D ata
Kavant
Rajpipla
Porbandar
Junagadh
_Urba n
_R ural
Amreli
_DT C
Palitana
Sa va r
ku ndla
Mangr ol
Mandavee
Kamrej
Vyara
Rajula
Una
Songadh
Nav sari
Vansda Ahwa
Gandevi
Chikhli
Valsad
Pardi
Gujarat: 75%
Nizar
Bardoli
Su ra t
Veraval
Dediapada
Hansot
Talaja
Keshod
CU P
Pavi_
Sank Jetpur
Padr a
Jetpur
Upleta
D'baria Garbada
Dhanpur
Go tri Ju b ili b a u gheda
Amod
Botad
Kotda S hangani
Bhilad
Jhalod
kh eda Dahod
Dhandhuka
Kham bhalia
Fatehp ura
Shahera
Mora Lim
Atars
umba
Petlad
Muli
Dhr ol
sura
G'nagar
_DT C Dahe
gam
Surendr a
nagar
#
Meghraj
Dharam pur
Kapr ada
3Q 2012
NSP Conversion Rate
BAN AS KAN TH A
PATAN
KAC HCHH
MAHESANA
SAB AR KAN TH A
1Q 2013
Expected : 90%
GANDH INAGAR
PA NCH
MA HALS
AMC
KHEDA
SURENDR ANAGAR
DAHOD
AHMED ABAD
VAD ODAR A
ANA ND
JAMNAGAR
CHHOTA
UDEP UR
VMC
RAJKOT
AR
ND
NARMADA
BA
R
PO
BHARUCH
NS P Conver sion Rate
< 84.5%
84.51% - 89.5%
> 89.5%
BHA VNAGAR
AMRELI
BAN AS KAN TH A
SURAT
JUNAGADH
VYARA
SMC
THE
DANGS
NAV SA RI
VALS AD
PATAN
KAC HCHH
MAHESANA
SAB AR KAN TH A
Gujarat State: 92%
GANDH INAGAR
PA NCH
MA HALS
AMC
4Q 2012
KHEDA
SURENDR ANAGAR
DAHOD
AHMED ABAD
VAD ODAR A
ANA ND
BAN AS KAN TH A
JAMNAGAR
CHHOTA
UDEP UR
VMC
RAJKOT
PATAN
MAHESANA
NARMADA
SAB AR KAN TH A
GANDH INAGAR
PA NCH
MA HALS
AMC
SURENDR ANAGAR
KHEDA
DAHOD
AHMED ABAD
VAD ODAR A
ANA ND
JAMNAGAR
CHHOTA
UDEP UR
VMC
RAJKOT
NS P Conver sion Rate
< 84.5%
84.51% - 89.5%
> 89.5%
BHARUCH
BHA VNAGAR
AMRELI
JUNAGADH
SURAT
SMC
VYARA
AR
ND
NARMADA
BHARUCH
BA
R
PO
NS P Conver sion Rate
< 84.5%
84.51% - 89.5%
> 89.5%
PO
RB
A
N
DA
R
KAC HCHH
NAV SA RI
BHA VNAGAR
AMRELI
JUNAGADH
SURAT
SMC
VYARA
NAV SA RI
VALS AD
THE
DANGS
VALS AD
Gujarat: 92%
Gujarat: 91%
THE
DANGS
NSP Conversion Rate
Expected : 90%
TB Units – Gujarat
Dhanera
Khedbrahma
Deesa
Danta
Rann of Kachchh
Diodar
Patan
Radhanpur
Bhiloda
Visnagar
Mehs ana
_DT C
Rapar
Himat
nagar Dhan
Ma nsa
Bhac hau
Kadi
Anjar
Viram
gam
Dhr angadhra
Mandv i
Morbi
Jamnagar_D TC
Idar
Kheralu
Cha na sma
Nak htrana
Bhuj_DT C
1st Quarter 2013
Palanpur
Vav
#
Bavla Matar
Balas
inor
Nadiad
Sarsa
Kham
bhat
DT C_Rural
An kla v
Santram
pur
Lalpur
Savli
Halol
Baroda
B aw ch a w a d
Bh aruch
Shihor
Porbandar
Valia
Ju nag adh
NSP C onve rsion Ra te
<= 8 4.5 %
84.5 1% - 89 .5%
> 89. 5%
No D ata
Kavant
Rajpipla
Babr a
Junagadh
_Urba n
_R ural
Amreli
_DT C
Palitana
Sa va r
ku ndla
Mangr ol
Mandavee
Kamrej
Vyara
Rajula
Una
Songadh
Nav sari
Vansda Ahwa
Gandevi
Chikhli
Valsad
Pardi
Gujarat: 91%
Nizar
Bardoli
Su ra t
Veraval
Dediapada
Hansot
Talaja
Keshod
CU P
Pavi_
Sank Jetpur
Padr a
Jetpur
Upleta
D'baria Garbada
Dhanpur
Go tri Ju b ili b a u gheda
Amod
Botad
Kotda S hangani
Bhilad
Jhalod
kh eda Dahod
Godhra
Dhandhuka
Kham bhalia
Fatehp ura
Shahera
Mora Lim
Atars
umba
Petlad
Muli
Dhr ol
sura
G'nagar
_DT C Dahe
gam
Surendr a
nagar
Meghraj
Dharam pur
Kapr ada
4Q 2011
NSP Success Rate
BAN AS KAN TH A
PATAN
KAC HCHH
MAHESANA
SAB AR KAN TH A
GANDH INAGAR
2Q 2012
Expected : 85%
PA NCH
MA HALS
AMC
KHEDA
SURENDR ANAGAR
DAHOD
AHMED ABAD
VAD ODAR A
ANA ND
JAMNAGAR
CHHOTA
UDEP UR
VMC
RAJKOT
AR
ND
NARMADA
BA
R
PO
BHARUCH
NSP Success Rate
< 80%
80% - 84.5%
> 84.5%
BHA VNAGAR
AMRELI
SURAT
JUNAGADH
BAN AS KAN TH A
VYARA
SMC
THE
DANGS
NAV SA RI
VALS AD
PATAN
KAC HCHH
MAHESANA
SAB AR KAN TH A
Gujarat State: 88%
GANDH INAGAR
PA NCH
MA HALS
AMC
1Q 2012
SURENDR ANAGAR
KHEDA
DAHOD
AHMED ABAD
BAN AS KAN TH A
VAD ODAR A
ANA ND
JAMNAGAR
PATAN
KAC HCHH
CHHOTA
UDEP UR
VMC
RAJKOT
MAHESANA
SAB AR KAN TH A
NARMADA
AR
AMC
SURENDR ANAGAR
KHEDA
DAHOD
AHMED ABAD
VAD ODAR A
ANA ND
JAMNAGAR
CHHOTA
UDEP UR
VMC
RAJKOT
AR
ND
NARMADA
BHARUCH
BHA VNAGAR
AMRELI
JUNAGADH
SURAT
SMC
VYARA
BHARUCH
BA
R
PO
NSP Success Rate
< 80%
80% - 84.5%
> 84.5%
NSP Success Rate
< 80%
80% - 84.5%
> 84.5%
ND
PA NCH
MA HALS
P
O
RB
A
GANDH INAGAR
BHA VNAGAR
AMRELI
JUNAGADH
NAV SA RI
SURAT
SMC
VYARA
NAV SA RI
THE
DANGS
VALS AD
VALS AD
Gujarat State: 87%
Gujarat: 86%
THE
DANGS
NSP Success Rate
Expected : 85%
TB Units – Gujarat
Dhanera
Khedbrahma
Deesa
Danta
Rann of Kachchh
Diodar
Patan
Radhanpur
Bhiloda
Visnagar
Mehs ana
_DT C
Himat
nagar Dhan
Ma nsa
Nak htrana
Bhac hau
Kadi
Anjar
Viram
gam
Dhr angadhra
Mandv i
Morbi
Jamnagar_D TC
Idar
Kheralu
Cha na sma
Rapar
Bhuj_DT C
2nd Quarter 2012
Palanpur
Vav
#
Bavla Matar
Balas
inor
Nadiad
Sarsa
Kham
bhat
DT C_Rural
An kla v
Santram
pur
Lalpur
Savli
Halol
Baroda
B aw ch a w a d
Bh aruch
Shihor
Porbandar
Valia
Ju nag adh
NSP S uc c e ss R ate
< 80%
80% - 84 .5%
> 84. 5%
No D ata
Kavant
Rajpipla
Babr a
Junagadh
_Urba n
_R ural
Amreli
_DT C
Palitana
Sa va r
ku ndla
Mangr ol
Mandavee
Kamrej
Su ra t
Una
Vyara
Songadh
Nav sari
Vansda Ahwa
Gandevi
Chikhli
Valsad
Pardi
Gujarat: 86%
Nizar
Bardoli
Rajula
Veraval
Dediapada
Hansot
Talaja
Keshod
CU P
Pavi_
Sank Jetpur
Padr a
Jetpur
Upleta
D'baria Garbada
Dhanpur
Go tri Ju b ili b a u gheda
Amod
Botad
Kotda S hangani
Bhilad
Jhalod
kh eda Dahod
Godhra
Dhandhuka
Kham bhalia
Fatehp ura
Shahera
Mora Lim
Atars
umba
Petlad
Muli
Dhr ol
sura
G'nagar
_DT C Dahe
gam
Surendr a
nagar
Meghraj
Dharam pur
Kapr ada
Rate of change in suspects examined per lakh population (compared to
same quarter in previous year) 2Q13 Vs 2Q12
-4.66%
-6.80%
-10.06%
-10.62%
Gandhinagar
Ahmedabad (R)
SMC
Patan
Dahod
Bhavnagar
Junagadh
Navsari
Banaskantha
Amreli
Panchmahals
Surendranagar
Surat (R)
Narmada
Chhotaudepur
Anand
VMC
Mehsana
Vadodara
-0.25%
(R)
-0.32%
Vyara
-0.48%
Valsad
-1.96%
Kachchh
-2.60% Rajkot
-3.00%
Sabarkantha
-3.50% Bharuch
-4.53%
Kheda
The Dangs
AMC
Jamnagar
Porbandar
30.78%
27.69%
27.14%
21.17%
20.43%
17.31%
15.67%
12.15%
11.31%
9.21%
9.16%
9.03%
8.74%
8.27%
7.48%
6.93%
5.42%
4.02%
Gujarat State : 7.2%
Rate of change in suspects examined per s+ case diagnosed (compared
to same quarter in previous year) 2Q13 Vs 2Q12
Gandhinagar
Patan
Surat (R)
Bhavnagar
Ahmedabad (R)
Junagadh
Dahod
Sabarkantha
Anand
SMC
Chhotaudepur
Rajkot
Navsari
Banaskantha
Surendranagar
Amreli
Vadodara (R)
Panchmahals
Kheda
The Dangs
VMC
Mehsana
-2.32%
Bharuch
-2.37%
Porbandar
-3.27% Jamnagar
-3.96%
Vyara
-4.15%
AMC
-5.30%
Valsad
-5.87%
Narmada
-7.95%
Kachchh
30.19%
22.59%
21.20%
17.08%
16.37%
15.45%
15.19%
14.38%
12.48%
12.47%
12.19%
11.41%
9.78%
9.27%
Gujarat State : 8.1%
7.44%
6.82%
3.28%
2.95%
2.81%
1.08%
0.78%
0.29%
Sputum conversion of NSP patients
registered in 4th quarter 2012
% of NSP smear coverted at the end of IP
% of NSP smear positive at end of three months
% of NSP w hose end of IP smear result Not available
VMC
AMC
87.1%
84.5%
92.1%
90.3%
90.7%
90.9%
90.2%
90.4%
91.4%
91.6%
92.5%
92.0%
92.3%
91.6%
93.7%
Sabarkant ha
Kachchh
Pat an
Jamnagar
Porbandar
Valsad
Kheda
Amreli
Rajkot
Chhot audepur
Navsari
Surendranagar
Bhavnagar
75%
1.7%
4.9%
80%
85%
11.2%
10.6%
0.0%
7.9%
1.9%
7.8%
1.6%
7.8%
1.5%
7.6%
2.2%
7.6%
2.0%
7.6%
1.4%
7.2%
1.3%
7.1%
0.5%
6.9%
1.1%
6.8%
1.0%
6.7%
2.0%
6.4%
0.0%
6.3%
90%
95%
100%
0%
82.8%
Narmada
100.0%
Dahod
94.2%
Vadodara (R)
97.6%
94.0%
Junagadh
Panchmahals
93.0%
88.0%
SMC
Gandhinagar
87.2%
100%
Vyara
84.7%
82.4%
Sabarkantha
Kheda
81.3%
Mehsana
79.2%
77.9%
Bhavnagar
Chhotaudepur
77.8%
76.3%
Ahmedabad (R)
Anand
75.7%
73.6%
Banaskantha
90%
Surat (R)
72.7%
71.0%
Bharuch
The Dangs
70.6%
69.2%
VMC
Porbandar
68.5%
63.8%
80%
Patan
Surendranagar
58.3%
55.7%
Rajkot
70%
Kachchh
55.4%
Navsari
50.0%
10%
Valsad
20%
50.0%
40%
Jamnagar
50%
48.9%
60%
AMC
22.2%
30%
Amreli
% of PHIs referring 2-3% of new adult OPD
Gujarat 2nd Quarter 2013
Trend of treatment outcomes in Re-treatment +ve Cases Gujarat
80%
Total -Cure
Total -Completed
Total -Died
Total -Failure
Total -Defaulted
Total -Transferred
out
70%
65%
64%64%65%65% 64%63%
63%
60%
60%
50%
67%
65%65%
65%65%64%66%
65%
64%65%
63%64%64%64% 63%
57%56%
56%
54%
53%
40%
30%
24%
22%
20%
21%
18%17%
18%17%16%
20%
16%
16%15%15%15%17%16%15%16%16%
16%15%
15%16%
15%
15%
14%14%
9%
8% 9% 9% 9%9%
10%9% 9% 10%9% 9% 10%9% 9% 9% 9% 10%
10%
10%10%8.70%
7%
9% 9%
9% 9%
9.10%
9%
8.20%
8% 7% 7% 7%
8% 8% 9% 9%
8% 9%
8.00%
7%8% 9%
7.90%
6% 6%
7
.70%
7.50%
7.30%
7%
7%
8%
7%
7%
6%
6%
4%
4%
5% 6% 5%
3%
2.90%
2%
2
2.10%
2% 2% 2% 2% 2% 2% 2% 2% 2% 2%
2%
1.70%
1.60%
1.50%
1.40%
1.50%
.50%
1.40%
1
.30%
1.30%
1.30%
1.10%
1.20%
1.20%
1%
1%
1%
1%
1%
1%
1%
1.00%
2%
2%
0%
2% 2% 2%
20%
1Q12
4Q11
3Q11
2Q11
1Q11
4Q10
3Q10
2Q10
1Q10
4Q09
3Q09
2Q09
1Q09
4Q08
3Q08
2Q08
1Q08
4Q07
3Q07
2Q07
1Q07
4Q06
3Q06
2Q06
1Q06
4Q05
3Q05
2Q05
1Q05
23%
Major indicators – Internal Evaluations-2Q13
District
Dahod
Junagadh
Bharuch
Navsari
Apr-13
May-13
May-13
June-13
Difference in NSP Cure rate b/w TB register and
Quarterly Reports
0.9%
2.1%
0.3%
0%
Difference in SP-RT Cure rate b/w TB register
and Quarterly Reports
1.1%
0.1%
0%
0%
DOT Rate in NSP interviewed
100%
90%
85%
95%
Place & Timing of DOT Convenient
90%
100%
100%
100%
Proportion of patients aware of their illness
100%
100%
100%
100%
Wrong Categorization
0%
10%
0%
5%
Aware about duration of Treatment
89%
89%
95%
95%
Attended a PP interaction meeting or community
meeting
11%
11%
10%
30%
Initial home visit has done
80%
90%
63%
90%
Eligible children received chemoprophylaxis
100%
90%
56%
Practicing proper cough etiquettes
37%
72%
71%
95%
Know their HIV status
21%
35%%
32%
30%
100%
Chest Symptomatic Referral Rate of Medical Colleges (1)
2Q12
7.0
3Q12
4Q12
1Q13
6.0
5.9
5.7
TB Suspects Examination Rate
6.0
5.3
5.0
4.4
4.2
4.0
3.8
3.6 3.6
3.4 3.5
3.4
3.0
3.8
3.5
3.33.2
2.9
2.7
3.0
2.4
2.0
2.22.22.1
2.0
2.02.12.12.1
2.4
1.9
1.3
1.1
1.0
0.0
BJMC Ahd NHLM, Ahd MP SHAH,
Jam
PDU, Raj
CU SHAH, GMC Bhav
Srn
L. G.
Hospital
GKGH,
Bhuj
Chest Symptomatic Referral Rate of Medical Colleges (2)
2Q12
9.0
8.2
3Q12
4Q12
1Q13
8.4
8.0
TB Suspects Examination Rate
7.1
7.0
6.6
6.0
4.9
5.0
5.1 5.2
5.4
5.0
4.8
4.5
4.1 4.2
4.0
4.9
4.5
4.0
3.0
2.0 2.0 2.0
2.0
2.2
1.0
0.0
GMC Vad
GMC Surat
SMIMER SMC
PS, Anand
PIPERIA Vad
7000
6000
5000
4000
3000
2445
2774
3118
3486
4351
4399
4736
4973
4938
5218
5335
5341
5154
5887
3412
3470
3540
3610
3799
3826
3889
3700
3818
3927
3721
4009
4610
4759
4812
4858
PP Involvement – Gujarat - since 2006
2000
1000
1Q06
2Q06
3Q06
4Q06
1Q07
2Q07
3Q07
4Q07
1Q08
2Q08
3Q08
4Q08
1Q09
2Q09
3Q09
4Q09
1Q10
2Q10
3Q10
4Q10
1Q11
2Q11
3Q11
4Q11
1Q12
2Q12
3Q12
4Q12
1Q13
2Q13
0
Contribution of PPs in RNTCP
1st Q 13
Patients
(no)
PPs involved
% of total of
state
4858
Referral of suspects
3018
2.1%
NSP patients put on DOTS
726
7.1%
Total TB patients put on DOTS
1455
7.1%
Referral of TB Suspects from Health Facilities
Gujarat 1st Quarter 2013
10%
9.80%
9%
8%
7%
5.80%
6%
4.80%
5%
4%
3.30%3.30%
3.10%
3%
2.80%2.80% 2.80%
2.40%
2.00%
2%
1.70%
1.10% 1.00%
1%
0.90%
0.00%0.00%0.00%
0%
DTC
UHC
NGOOther
PHC
NGOTB
Med
Col
NGOGIA
CH-GH
CHC
GasPetrl
Corpo
Sec
ESIS
Jail
Rly
State
Disp
CGHS
Steel- Arm ed
Mines Force
2849
3892
9821
98248
6878
50005
82424
15654
351
17656
New Adult OPD
78512 218478 60110 1167669 2551
534404 99126 557333
Referred Cases
7709
12681
2866
38854
83
16704
2819
15494
79
92
201
1672
73
516
783
5
0
0
% of referral
9.80%
5.80%
4.80%
3.30%
3.30%
3.10%
2.80%
2.80%
2.80%
2.40%
2.00%
1.70%
1.10%
1.00%
0.90%
0.00%
0.00%
0.00%
ESIS Referral of TB Suspects
Gujarat 1st Quarter 2013
5%
4%
3.70%
3.40%
3.00%
3%
2.80%
2.60%
2.30%
2.30%
2.20%
2.20%
2%
1.50%
1.30%
1.10%
1%
0.30%
0%
0.00%
Panchm Bhavnag
Mehsan Jam nag
Valsad
ahal
ar
a
ar
SMC
VMC
Bharuch
Kheda
AMC
Rajkot
Navsari
0.00%
Surendr Gandhin
Surat (R)
anagar
agar
New Adult OPD
405
383
3727
2594
343
5162
12185
2159
463
64135
792
440
3886
1333
241
Referral
15
13
112
73
9
118
278
48
10
950
10
5
10
21
0
3.70%
3.40%
3.00%
2.80%
2.60%
2.30%
2.30%
2.20%
2.20%
1.50%
1.30%
1.10%
0.30%
0.00%
0.00%
%
NGOs Involvement – Gujarat
300
270 265267266267
263
261
254
251256
244
237
250
225
200
Reporting
format
changed
190191
165
162160
153155 152157 153
140
141 144142
131
150
107
100
95
50
1Q06
2Q06
3Q06
4Q06
1Q07
2Q07
3Q07
4Q07
1Q08
2Q08
3Q08
4Q08
1Q09
2Q09
3Q09
4Q09
1Q10
2Q10
3Q10
4Q10
1Q11
2Q11
3Q11
4Q11
1Q12
2Q12
3Q12
4Q12
1Q13
2Q13
0
Involvement - as a DOT Provider in RNTCP
2Q13
CBVs, 8.7%
Govt. Health Worker,
17.3%
Gram Mitra, 0.7%
Contractual TBHVs,
1.3%
AWW, 8.6%
PPs, 9.0%
ASHA, 52.9%
NGOs, 0.8%
Cured Pts, 0.7%
Status of Staffing
No. of MOTCs vacant (5 / 144)
– Jamnagar (2), Kheda (1), Narmada (1), VMC (1)
No. of Contractual STSs vacant (5 / 144)
– Kheda (2), Surendranagar (2), VMC (1)
No. of Contractual STLSs vacant (4 / 144)
– Bharuch (2), Panchmahals (1), Valsad (1)
No. of Contractual TBHVs vacant (17/203)
– AMC (9), Banaskantha (1), Bharuch (1),
Dahod (1), Panchmahals (1), Porbandar (1),
Rajkot (1), VMC (2)
Status of Training
• Untrained MO-TCs (6)
– Bhavnagar (1), Junagadh (1), Porbandar (1), The Dangs (1),
VMC (2)
• Untrained STS (5)
– AMC (1), Anand (1), Chhotaudepur (1), Surat-R (1),
Vadodara-R (1)
• Untrained STLS (7)
– Anand (1), Bhavnagar (1), Dahod (1), Narmada (1), Navsari (1),
Panchmahals (1), Surat-R (1)
• Number of DMC LTs untrained (14)
– Banaskantha (2), Navsari (5), Sabarkantha (4), The Dangs (1),
VMC (2)
Thank You