22 November 2018 | News
Focus on increasing notification from private doctors
The Indian Medical Association (IMA) has recently highlighted various efforts to achieve the Government of India’s vision to ‘End TB’ as part of a joint collaboration with the Government to reach out to every private doctor and through them to every TB patient in the state of Madhya Pradesh.
The press conference focused on the importance of involvement of private doctors in the overall effort for an increase in the notification of TB cases which is an important tool in the fight against the dreaded disease. The annual number of TB cases notified by private providers needs to increase ten-fold, from 0.2 to 2 million annually by 2020.
As per the latest available data, the number of TB patients notified in MP during 2017 was 1,34,333 with 1,870 drug resistant TB cases were diagnosed. Out of this, 12% TB patients were notified from private sector. Services have been expanded in the state to cater to all forms of TB patients with 818 microscopy services, state-of-the-art 73 Cartridge Based Nucleic Acid Amplification Test (CBNAAT) laboratories, 4 culture and DST laboratories and 24 drug resistant TB centers.
IMA will galvanize the private doctors to increase notification and work toward the cause of ending TB by optimal utilization of the Government’s notification system, NIKSHAY. The IMA will inform and encourage private doctors to take advantage of the various facilities made available by the Government under the Revised National Tuberculosis Control Program (RNTCP) for the benefit of patients seeking care from the private sector, including free diagnosis, drugs and NIKSHAY Poshan Yojana under which every TB patient gets Rs.500/- per month towards nutrition support till completion of treatment.
Addressing the media, Dr. Ravi Wankhedkar, National President, IMA said, “India has the largest burden of Tuberculosis in the world. Notification of every TB patient is the single most important intervention to meet the Government’s vision of a TB free India. The state branch of IMA will address this and encourage all private doctors to notify every TB patient in order to achieve goal of ‘End TB’ in Madhya Pradesh.If patients are detected early and accurately, it gives an opportunity to treat them early and prevent infection further.”
Highlighting a successful intervention in the city of Indore, Dr. Wankdhekar said, “The city has been able to detect more pediatric cases at 9% of all notified cases which is a positive sign. This has resulted from the successful Government project targeting TB in children in Indore where doctors from public and private sectors were supported to utilize CBNAAT for diagnosis of TB in children which is otherwise difficult due to failure of children to expectorate or spit out. For treatment, child friendly dispersible and flavored fixed dose combinations (FDCs) are made available for children.”
IMA will be conducting targeted CMEs in Madhya Pradesh over the next few months to sensitize private doctors on newer updates in management of TB and various benefits provided by the Government for patients and providers. Patient notification through the Nikshay app has multifold benefits for the patient, including patient home visits, counseling of the TB patient and family members and follow ups on adherence to treatment plans. Notification also benefits the doctors with access to free drugs and diagnostic tests as per the Standard for TB Care in India.
Expanding on the efforts to increase notifications by the private sector, Dr. R V Asokan, Chairman IMA End TB Initiative said, “NIKSHAY has been upgraded to amore user friendly version 2.0 that is compatible with both web based and app based platforms. Private doctors can also use other methods including the Government’s call centre at 1800-11-6666 for notification of TB patients. A significant challenge faced in eradicating tuberculosis is the premature stopping of treatment by patients. Incentive schemes for the patients and doctors are available in this regard. The NIKSHAY Poshan Yojana also targets this through monetary support for patients. Chemists can also do Schedule H1 reporting through a mobile app initiated by the Government of Madhya Pradesh.”
Dr. R V Asokan, took the media through the initiatives to tackle drug resistant TB. He said, “Madhya Pradesh has increased drug resistance TB treatment centers from 9 to 24 taking it to the district level. Universal Drug Susceptibility Testing has been introduced for TB patients before initiation of treatment for early diagnosis of drug resistance cases. As a result, all drug resistant TB patients are treated now with shorter regimen of 9-11 months as compared to conventional 24 months treatment which ensures better compliance and complete treatment. The new drug, Bedaquline is now available for patients with resistance to fluoroquinolone or injectable drugs.”
Through CMEs and key messages through social media communication, the IMA and the Government will collaboratively reach out to private doctors for universal coverage of these services in the stateand ensure all TB patients are notified, linked with these services and provided benefits.