PROVINCIAL TUBERCULOSIS CONTROL PROGRAM SINDH - NTP

Document Sample
PROVINCIAL TUBERCULOSIS CONTROL PROGRAM SINDH - NTP Powered By Docstoc
					     PROVINCIAL
TUBERCULOSIS CONTROL
   PROGRAM SINDH

     JUNE 19-20,2009
     DR. Ismat Ara
   PTP Manager Sindh
                          Organogram
Technical Support          Secretary Health
from NTP
                              DG Health

1 PTO
                             Director TB
3 NPOs                         Control
1 ACSM Coordinator             Program
1 Microbiologist
4 SLSs
               Deputy       Deputy            Deputy     Deputy
               Director     Director          Director   Director
               Hyderabad    Karachi           Sukkur     Larkana
              SINDH
Population            38.508 million
Districts             23

Infra structure TB-DOTS
 BMUs                 265
 Treatment Centers    948
 LHWs    More Than   21000
 PROGRESS
INDICATORS
   SINDH


CASE FINDING
              CDR (All Types)
NTP TARGET ACHIEVED & SUSTAINED

80%

70%                                             70% 70% 71%
                                          63%
60%                                 57%
50%                           49%

40%                     37%
30%
                  24%
20%
           16%
10%
      2%
 0%
      2000 2001   2002 2003   2004 2005   2006 2007 2008    Q1,
                                                           2009
                  CDR New SS+
      NTP TARGET ACHIEVED & SUSTAINED

80%
70%                                      73% 74% 71%
                                   65%
60%
                             56%
50%
40%                    41%
30%
                 27%
20%        20%
        14%
10%
0% 1%
    2000 2001 2002 2003 2004 2005 2006 2007 2008 Q1,
                                                 2009
PROGRAM IS MANAGING A HUGE
NUMBER OF TB CASES IN THE PROVINCE

        SS+ NEW & ALL TB CASE REGISTRATIONS IN SINDH-2003-2008


50000                                                      46762
                                                 45685
45000
                                       40409
40000                        36619
35000
                   30191
30000
         23061                                                     S++ NEW
25000                                          21600     22283
                                     18812                         ALL TB CASES
20000                      16055
15000            12105
10000   8043

5000
   0
         2003     2004      2005      2006      2007      2008
  PPM-IMPROVING POPULATION
  COVERAGE
      CONTRIBUTION OF PRIVATE SECTOR TO CASE DETECTION
           OF SS+ NEW CASES IN PROVINCE OF SINDH

25%
        24%
24%
24%
                   23%        23%
23%
23%
                                                    22%
22%                                                          Series1
22%
                                         21%
21%
21%
20%
20%
      Q1, 2008   Q2, 2008   Q3, 2008   Q4, 2008   Q1, 2009
      QUALITY OF DIAGNOSIS IS IMPROVING


                    NEW CASE REGISTRATIONS IN SINDH


60%

                  49%         50%         50%
50%   47%                                             48%


40%    38%         38%
                               36%         36%         36%
                                                                  S++ New
30%                                                               Smear-Negative
                                                                  E.Pulmonary
20%                                                         16%
            15%                     14%         14%
                        13%
10%


0%
       2005        2006        2007        2008       Q-1,2009
       SINDH

PROGRESS INDICATORS
     SINDH
  CASE HOLDING
                             TSR
NTP TARGET ACHIEVED & SUSTAINED

 90%
                                                        88%
                                                               87%
 85%                                             84%
                                          81%
 80% 79%                           79%
                            76%
 75%                 75%
              74%

 70%

 65%
       2000   2001   2002   2003   2004   2005   2006   2007    Q1,
                                                               2008
                      DEFAULT RATE
                      FIELD OF CONCERN

30%
      26%
25%

20%
             17%
15%                 15% 15%
                                  14%
                                         12%
10%                                             10%
                                                       6%     6%
5%

0%
      2000   2001   2002   2003   2004   2005   2006   2007    Q1,
                                                              2008
  DEFAULT IS HIGH DURING INTENSIVE PHASE

  (1356 SS+ CASES DEFAULTED DURING YEAR 2007)

              DEFAULT IS HIGH DURING INTENSIVE PHASE IN SINDH


450
                        398
400
            344                                             350
350                                 327
                  292                           287
300
      245                                                         INTENSIVE PHASE
250                           222
                                                      208         CONTINUATION PHASE
200                                       170                     TOTAL
                                                       142
150                                        117
        99         106         105
100

50

 0
      Q-1,2007 Q-2,2007 Q-3,2007 Q-4,2007 Q-1,2008
Issues-1
   Pc-1 submitted-cuts expected !
   P&D refused to include funds for MDR
    TB,PPM & PRL in PC-1 with out
    knowledge on NTP support
   Funds only to purchase 50% drugs
    required during 2009-2012
   A meagre amount of 17 M for ACSM
    during 2009-2012
                    ISSUES-2
1.   Default is high
2.   Establishment of Reference lab at intermediate level
3.   Resources to manage MDR TB
4.   Implement PPM to extend free & quality management to
     all TB patients in Sindh
5.   Drug Management
6.   Suspects and cases in females are low in many districts
     compared to males- TB is low in females or Stigma ?
7.   Retaining trained staff; and Involvement of DTC and
     DOTS staff in other program
8.   POL for DTCs & DLS
PROGRAM NEEDS SUPPORT TO
ADDRESS PROBLEM OF DEFAULT
   Pre-paid envelopes for all BMUs
   Food support for patients & treatment
    supporters
   Mobility for TB-DOTS facilitators at least in
    DHQ hospitals
   Intense & target oriented ACSM activities
   Urgent involvement of GPs in the program
ALLAH HAFIZ

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:3
posted:3/7/2013
language:Latin
pages:17