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  1. Narayana Holla
  2. Service delivery
  3. Friday, 06 September 2019

Dear viewers in view of the following context we [KVG team] wish share the attached.

Context: The Union Government has rolled out a programme for universal screening of an estimated 250 million children and adolescents below 18 years annually for Leprosy and Tuberculosis (TB) and put on treatment if required. TB kills an estimated 4.8 lakh Indians (sharing 31% of global TB deaths) every year [>1,400 every day]. India has highest TB burden (27% of the world) with more than a million ‘missing’ cases every year that are not notified – either undiagnosed, unaccountable, inadequately diagnosed and treated in the private sector. (https://indianexpress.com/article/india/govt-rolls-out-scheme-to-screen-all-children-below-18-for-leprosy-tb-5943004/ accessed on 06-09-2019).

In this regard Manotux test [TST] has a definite role. Tuberculin Skin Test (TST) is a simple and reasonably reliable method for the detection of infection by Mycobacterium tuberculosis. It is a diagnostic aid for corroborating with clinical findings though not a confirmatory test.

Quote: It has to be approached “with respect, administered with care, read with deliberation and interpreted with sentient discrimination.”

All the 8 rights to be observed before / while and after administering vaccines are applicable to Tuberculin also plus 2 more: a) Do’s and Don’ts for the patient during the reactogenic period; b) reading the test between 48 and 72 hours without fail.

In almost all Medical Colleges visited in 4 states, tuberculin manufactured by “arkray” with different strengths is used: viz. 1TU, 2TU, 5TU and 10TU RT23 in 0.1mL, 5mL per vial providing 50 ID doses of 0.1mL each. Though the test is in practice since 1907, many programmatic errors in various permutation combinations were observed in different thematic areas of administering / reading TST. 

What we did:

  1. Charity should begin at home. We established nursing station for administering tuberculin skin test in he dedicated vaccination clinic in KVG Medical College.
  2. Developed a Supportive Supervision checklist as per CDC and RNTCP guidelines, used the same in the capacity building of testers and the officers in various Medical Colleges.
  3. Regularly shared the observations with DTF, STF, ZTF and NTF.
  4. We appraised the visitors to our college.
  5. As directed by the State Task Force, in collaboration with DTO, conducted training workshops to the Matron, testers of Medical Colleges of home district at the “Demo-site” of KVG Medical College.
  6. As directed by STF, experiences of training workshop presented in the STF meeting at State Institute of Health and Family Welfare on 7th June 2019.

Way forward: Conducting similar CMEW in all the Medical Colleges of Karnataka for sensitization followed by intensive training of testers in small batches at the “Demo-site” in KVG Medical College.

Acknowledgement: Thanks to the supporters of End TB programme.

Please find the attached for additional inputs from the viewers.

with regards

Holla n team

 

 

 

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