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Deputy Director [TB]
Distict Headquarters Hospital
Nagapattinam-611 001
District Collectorate

Boat on FishingTourism Plays a Key Economy for the District even though Agriculture and Fishing are the Major ones. Shrines, Places of Hindu Faith, Mosques forms the Spiritual Tourism for the district. Annual Festivals and functions marks glory of the Year. Heritages like Tarangam padi Fort, Poompuhar speaks of the rich civilization of this land.  

Danish FortThis was the only busy trade centre on the Coromandal coast for the Danes.This fort was declared as a protected monument by the Department of Archaeology, Government of Tamilnadu in 1977 ADThe Danes constructed fortifications on the coast at Tranquebar. This fort was a busy trade centre till 1845 AD when the Danes handed over the fort to the English. It was used as a Public Works Department Travellers Bungalow for government servants and colonials till 1977 AD.  



As everyone is aware that tuberculosis is affecting huma population since time immemorial. The most intelligent & powerful race on earth has not been able to conquer one of the weakest organism which get destroyed even by exposure to sunlight or even by bleaching powder. Where have we gone wrong. We have been able to wipe out dreaded disease the like Small Pox from the face of earth, we have almost made this world Polio free.

We need a zeal to put our knowledge and resources in concerted manner to carry out a multipronged attack in this "Battle Royal" of Mankind vs. Tuberculosis. Our enemy has found out a powerful ally in the form of HIV / AIDS to make a deadly combination. The disease which became non existent in the developed world has started developing its tentacles to grip the human race.

Every country had started a National Control Programme after the discovery of M.tuberculosis as causative organism by Robert Koch on 24 March 1882 and discoveries of Anti TB drugs since 1944. But we failed. Viewing this WHO declared tuberculosis as a 'Global Emergency' since it is creating a havoc.

  • One Third of Population in infected by M.tuberculosis.
  • Every year there are 9 million new cases and 3 million deaths.
  • 95% of TB Cases and 98% of TB deaths out of which 25% are avoidable are in developing countries.
  • In India, 14 millions people are suffering from TB out of which 3.5 million are Infectious cases.
  • Every year there are 5 lakh deaths i.e., one person dying every minute due to tuberculosis in India. DOTS (Directly Observed Treatment Short Course) Strategy was developed and has been incorporated in India as Revised National Tuberculosis control Programme.
District TB Programme

Based on the findings of the operational studies conducted, a draft recommendation for the District Tuberculosis Programme was prepared in 1961, keeping in mind an average Indian district, its population and health facilities available.
The national programme policy as enunciated in the introduction manual of DTP comprised

  • Domiciliary treatment.
  • Use of a standard drug regimen of 12-18 months duration.
  • Treatment free of cost.
  • Priority to newly diagnosed patients, over previously treated patients.
  • Treatment organization fully decentralized.
  • Treatment organization fully decentralized.
  • Efficient defaulter system/mostly self-administered regimen.
  • Timely follow up.
  • Chemoprophylaxis not recommended as it is impractical on mass basis.
Formulation of the RNTCP

In the light of the recommendations and concerns expressed by the Central Health Council, steps were taken since 1993 to implement the Revised National TB Control Programme (RNTCP) in selected areas with World Bank assistance.

The RNTCP builds on the very substantial strengths and accomplishments of the National Tuberculosis Programme (NTP).

The RNTCP strengthens the existing NTP infrastructure by creating a sub-district-level supervisory team (known as the TB Unit), consisting of a treatment supervisor (Senior Treatment Supervisor, STS) and a laboratory supervisor (Senior TB Laboratory Supervisor, STLS). These are new posts. In addition, a medical officer from the general health system serves as Medical Officer-TB Control at sub-district level who is specifically allocated TB control duties in addition to his other duties. These 3 individuals constitute the management unit, which is responsible for overseeing operations in approximately a 5 lakh population including, on average, 5 designated microscopy centers. All these three staff have been made mobile by giving vehicle/POL inputs. At each microscopy centre, a state-of-the art binocular microscope, good quality reagents and new recording and reporting proformae are available. More importantly, intensive modular training, supervision, and cross-checking of the work of the laboratory technician should ensure that reliable results are obtained.

The goal of RNTCP is to cure at least 85% of new smear-positive cases of tuberculosis and to detect at least 70% of such patients, after the desired cure rate has been achieved. Clearly, both good outcomes and high case detection rates are essential. But it is essential that the system is geared up to reliably cure patients, before any attempts are made at expanding case detection. In fact, experience clearly shows that reliably curing patients results in a 'Recruitment effect'- wherever effective services are offered, case detection rates steadily increase. Cured patients act as one of the best motivators promoting case detection and patient adherence to treatment.

The basic principles of the RNTCP are

  • Political commitment to ensure adequate funds, staff, and other key inputs.
  • Diagnosis primarily by microscopy of patients presenting to health facilities.
  • Regular and uninterrupted supply of anti-TB medications including the use of a patient-wise box which contains the entire course of treatment for an individual patient so that no patient should ever stop treatment for lack of medicines.
  • Direct observation of every dose of treatment in the intensive phase and at least the first dose in the continuation phase of treatment.