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The provincial TB program is struggling to detect, treat and cure patients with infectious TB. To this end, primary health care services are involved and the necessary diagnostic and treatment facilities are made available to all levels of health care institutions and private doctors and hospitals.
The program organized treatment as close as possible to the patient's home in order to minimize barriers to access in 644 TB treatment centers.
The program has started the mandatory search of contacts. Contacts are being investigated with symptom search, BCG, TCT and / or IGRA vaccination status and chest x-ray.
Active TB will develop in about 6% of people with latent TB infection who do not receive preventive treatment. 60-70% case reduction rate due to preventive treatment. To achieve this program began post-exposure therapy.
The program provides diagnostic facilities in 644 basic management units distributed throughout Punjab, including tertiary care institutions, district, district, Tshsil Head Head and rural health centers, where laboratories have been modernized for microscopy, including LED / FM microscopy and logistical support. Evan solar panels have been supplied for uninterrupted power supply.
160 Gene Xpert machines have been installed in tertiary care centers, district health centers, Tehsil district hospitals and rural health centers where the test is provided free of charge (market price of Rs 4,000). Ten other machines are being installed.
Gene Xpert is an advanced and sensitive test for the diagnosis of drug-susceptible and drug-resistant TB. 36 intermediate laboratories, one in each district were set up. Four culture labs have been established: one in Lahore, Faisalabad, Sialkot and Bahawalpur, and another in Sargodha under construction.
The program examines the high-risk population (children, patients with HIV, diabetes and COPD), public hospitals (OPD medical), prisons, workplaces via mobile vans. PTP is committed to strengthening the cooperation and coordination between all management stakeholders such as non-governmental organizations, parastatal hospitals: WAPDA, railways, PESSI, etc., large private hospitals and professional societies.
The program includes monitoring and follow-up initiatives: effective drug supply and drug management system (TB-DMIS), notifiable Android TB application, management application, monitoring and evaluation of testing camps, Gene Xpert complaint management information system (MIS), district coordinator (DTC / TB focal person) App and TB DME (TB-03 case-based system).
The program has developed a training program and training for all staff involved in TB-DOTS physicians to improve TB diagnostic and treatment capacity and their quality. . The provincial tuberculosis reference laboratories in Lahore and Multan are working effectively for drug susceptibility testing and training of laboratory staff in the province. In Lahore, the provincial reference laboratory has been modernized and offers drug susceptibility testing (DST) and tuberculosis testing for more general indications such as at-risk population and clinical risk groups; paramedical (DOTS facilitator) for recording and reporting, laboratory tests on AFB staining, Gene-Xpert, culture techniques and DST, early detection of cases and contact search by Lady health workers, management and drug storage for warehousers, and data operators on MIS, DIMS.
The program managed a rapid badessment of a suspected case of pulmonary tuberculosis through training and continuing medical education programs of the medical and paramedical staff of the provincial health department of the facility.
The WHO DOTS strategy is the one that best cures TB patients. It is implemented in all TB care settings and case retention strategies such as the TB-MIS registration and the tracking system 'TB-SMS Automatic Alert System', LHW follow-up home visits, The "Hospital DOTS Link" notification system to improve case processing and effective monitoring by the program is being implemented in Punjab.
The treatment and management of multidrug-resistant tuberculosis (MDR) is costly, prolonged and badociated with many adverse drug reactions, contributing to poor adherence, further increasing the prevalence of MDR-TB. To combat the threat of multidrug-resistant TB, the program has established eleven centers (PMDT site) offering free specialist advice, a free second-line drug supply and comprehensive social and psychological support.
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