REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME
The Revised National Tuberculosis Control Program was launched in India in 1992. The focus of TB treatment shifted from the patient to the caregiver. Sputum microscopy became the Gold Standard of TB diagnosis and Directly Observed Treatment Shortcourse (DOTS) became an essential component of RNTCP. Mizoram implemented RNTCP in 2003 and Programmatic Management of Drug Resistant Tuberculosis (PMDT) erstwhile DOTS Plus in 2011.
The goal of RNTCP is to reduce the mortality and morbidity associated with TB until it ceases to be a public problem and to cut the chain of transmission. These goals are achieved by the following objectives:
- To achieve and maintain Cure Rate of 85% among New Smear Positive patients.
- To achieve and maintain a Case Detection Rate of at least 70% of the expected New Smear Positive pulmonary TB cases among the community.
In basic RNTCP services, diagnosis is made by Sputum Microscopy. In Mizoram there are a total of 34 places where sputum can be examined. For PMDT services, diagnosis is made by a molecular method known as Cartridge Based Nucleic Acid Amplification Test (CBNAAT) which is placed in DR-TB Centre, Falkawn. This type of test takes approximately 2 hours only. The then TB Hospital located in Zemabawk has now been shifted to DR-TB Centre, Falkawn. However, only MDR-TB and XDR-TB patients are admitted because domiciliary treatment has been found to be as effective as sanatorium treatment for other TB patients except these two.
Aizawl District – DTC Aizawl, Presbyterian Hospital (Durtlang) MC, Aibawk MC, Sialsuk MC, Lengpui MC, Thingsulthliah MC, Saitual TU, Darlawn TU, Sakawrdai MC, Suangpuilawn MC, Kulikawn Hospital TU leh Aizawl Hospital MC.
Mamit District – DTC Mamit, Kawrthah MC,W. Phaileng MC leh Marpara PHC.
Kolasib District – DTC Kolasib, Vairengte MC.
Serchhip District – DTC Serchhip, N.Vanlaiphai MC, Thenzawl MC
Lunglei District – DTC Lunglei, Hnahthial TU, Tlabung MC, Serkawn Hospital MC
Lawngtlai District – DTC Lawngtlai, Chawngte MC, Sangau MC.
Saiha District – DTC Saiha, Tuipang MC
Champhai District– DTC Champhai, Khawbung MC, Ngopa MC, Khawzawl MC
The different treatment regimens for Tuberculosis include the following categories:
- Category I : For New cases.
- Category II : For Previously Treated cases.
- Category IV : For Multi Drug Resistant TB (MDR-TB) cases.
- Category V : For Extensively Drug Resistant TB (XDR-TB) cases.
RNTCP offers a variety of honorarium to patients who have successfully completed treatment as well as to the voluntary DOT Providers who have diligently ensured that patients are taking regular treatment.
Provider | Amount |
Cat-I | Rs1000/- |
Cat-II | Rs1500/- |
Cat-IV | Rs5000/- (IP-2000,CP-3000) |
Beneficiary | Amount |
Patients on completion of treatment | Rs 750/- |
Travel cost of MDR-TB to DR-TB center(outside district) | Upto Rs 1000/- |
Travel cost of MDR-TB to DR-TB center (within district) | Upto Rs 400/- |
Injection Prick | Rs 25/injection |
Volunteers for sputum transport | Rs 25/sputum |
Achievements/Performance 2023-2024
- Presumptive TB Examination : The testing rate target for Mizoram is 30/1000 population. The projected NTEP population for Mizoram was 13.19 lakhs for 2023. The desired testing rate = 39570 for 13.19 lakhs population.
The current testing rate = 15249 for 13.19 lakhs population. Achieved = 38.53%
S/No. | District | No. of presumptive TB examined between April 2023 to March 2024 |
1 | Aizawl | 7680 |
2 | Champhai | 1365 |
3 | Kolasib | 1775 |
4 | Lawngtlai | 641 |
5 | Lunglei | 1828 |
6 | Mamit | 659 |
7 | Siaha | 603 |
8 | Serchhip | 15249 |
TB Notification :
Target for 2023 was 3000. Achieved = 2202 or 73.40%
S/No. | District | No. of TB notified between April 2023 to March 2024 |
1 | Aizawl | 1531 |
2 | Champhai | 98 |
3 | Kolasib | 147 |
4 | Lawngtlai | 103 |
5 | Lunglei | 138 |
6 | Mamit | 24 |
7 | Siaha | 116 |
8 | Serchhip | 45 |
2. TB HIV Services : The desired testing rate is 100% for all TB patients. Achieved : 98%
S/No. | District | TB Notified | Tested | Test % | Positive | Positive % |
1 | Aizawl | 1317 | 1296 | 98 | 175 | 14 |
2 | Champhai | 148 | 148 | 100 | 18 | 12 |
3 | Kolasib | 186 | 181 | 97 | 22 | 12 |
4 | Lawngtlai | 133 | 123 | 92 | 6 | 5 |
5 | Lunglei | 150 | 149 | 99 | 16 | 11 |
6 | Mamit | 76 | 75 | 99 | 6 | 8 |
7 | Siaha | 118 | 117 | 99 | 8 | 7 |
8 | Serchhip | 69 | 67 | 97 | 7 | 10 |
| MIZORAM | 2197 | 2156 | 98 | 258 | 12 |
3. TB Treatment Outcomes :
- Success Rate
S/No. | District | TB Notified | Cured + Treatment Completed | Success Rate |
1 | Aizawl | 1128 | 935 | 83% |
2 | Champhai | 141 | 130 | 92% |
3 | Kolasib | 177 | 162 | 92% |
4 | Lawngtlai | 96 | 67 | 70% |
5 | Lunglei | 157 | 142 | 90% |
6 | Mamit | 41 | 33 | 80% |
7 | Siaha | 129 | 122 | 95% |
8 | Serchhip | 80 | 71 | 89% |
| MIZORAM | 1949 | 1662 | 85% |
b. Died
S/No. | District | TB Notified | Died | % |
1 | Aizawl | 1128 | 62 | 5% |
2 | Champhai | 141 | 9 | 6% |
3 | Kolasib | 177 | 7 | 4% |
4 | Lawngtlai | 96 | 1 | 1% |
5 | Lunglei | 157 | 6 | 4% |
6 | Mamit | 41 | 7 | 17% |
7 | Siaha | 129 | 4 | 3% |
8 | Serchhip | 80 | 4 | 5% |
| MIZORAM | 1949 | 100 | 5% |
c. Failure
S/No. | District | TB Notified | Failure | % |
1 | Aizawl | 1128 | 3 | 0% |
2 | Champhai | 141 | 0 | 0% |
3 | Kolasib | 177 | 1 | 1% |
4 | Lawngtlai | 96 | 0 | 0% |
5 | Lunglei | 157 | 2 | 1% |
6 | Mamit | 41 | 0 | 0% |
7 | Siaha | 129 | 0 | 0% |
8 | Serchhip | 80 | 0 | 0% |
| MIZORAM | 1949 | 6 | 0% |
d. Regimen changed
S/No. | District | TB Notified | Regimen changed | % |
1 | Aizawl | 1128 | 23 | 2% |
2 | Champhai | 141 | 0 | 0% |
3 | Kolasib | 177 | 2 | 1% |
4 | Lawngtlai | 96 | 0 | 0% |
5 | Lunglei | 157 | 4 | 3% |
6 | Mamit | 41 | 0 | 0% |
7 | Siaha | 129 | 0 | 0% |
8 | Serchhip | 80 | 2 | 3% |
| MIZORAM | 1949 | 31 | 2% |
e. LTFU
S/No. | District | TB Notified | LTFU | % |
1 | Aizawl | 1128 | 38 | 3% |
2 | Champhai | 141 | 0 | 0% |
3 | Kolasib | 177 | 5 | 3% |
4 | Lawngtlai | 96 | 0 | 0% |
5 | Lunglei | 157 | 1 | 1% |
6 | Mamit | 41 | 1 | 2% |
7 | Siaha | 129 | 0 | 0% |
8 | Serchhip | 80 | 0 | 0% |
| MIZORAM | 1949 | 45 | 2% |
f. Not evaluated
S/No. | District | TB Notified | Not evaluated | % |
1 | Aizawl | 1128 | 6 | 1% |
2 | Champhai | 141 | 1 | 1% |
3 | Kolasib | 177 | 0 | 0% |
4 | Lawngtlai | 96 | 3 | 3% |
5 | Lunglei | 157 | 0 | 0% |
6 | Mamit | 41 | 0 | 0% |
7 | Siaha | 129 | 0 | 0% |
8 | Serchhip | 80 | 0 | 0% |
| MIZORAM | 1949 | 10 | 1% |
4. Ni-kshay Poshan Yojana
S/No. | District | Amount payable | Amount paid | % |
1 | Aizawl | 4670500 | 2794000 | 60% |
2 | Champhai | 449000 | 270500 | 60% |
3 | Kolasib | 581500 | 356500 | 61% |
4 | Lawngtlai | 370000 | 198000 | 54% |
5 | Lunglei | 432500 | 323000 | 75% |
6 | Mamit | 235000 | 153500 | 65% |
7 | Siaha | 390000 | 241000 | 62% |
8 | Serchhip | 218500 | 87000 | 40% |
| MIZORAM | 7347000 | 4423500 | 60% |
5. PMDT Reports
S/No. | District | Tested for MDR TB | Diagnosed as MDR TB | Success Rate |
1 | Aizawl | 6144 | 117 | 70% |
2 | Champhai | 550 | 12 | 100% |
3 | Kolasib | 122 | 11 | 57% |
4 | Lawngtlai | 57 | 3 | 100% |
5 | Lunglei | 880 | 4 | 100% |
6 | Mamit | 380 | 4 | 66% |
7 | Siaha | 554 | 2 | 0% |
8 | Serchhip | 632 | 7 | 0% |
| MIZORAM | 9319 | 160 | 71% |
6. Pradhan Mantri TB Mukt Bharat Abhiyaan
Sl. No |
District
| Number Ni-kshay Mitra agreed to Support
| TB patients on Treatment
| TB patients consented to receive Community Support
| TB patients declined to receive community support
| TB Patients consent pending
| Total kits distributed (all time period)
|
1 | Aizawl | 72 | 912 | 796 | 2 | 114 | 1363 |
2 | Champhai | 15 | 76 | 66 | 0 | 10 | 193 |
3 | Kolasib | 47 | 108 | 108 | 0 | 0 | 476 |
4 | Lawngtlai | 6 | 104 | 93 | 1 | 10 | 66 |
5 | Lunglei | 16 | 72 | 56 | 0 | 16 | 195 |
6 | Mamit | 11 | 45 | 41 | 0 | 4 | 280 |
7 | Siaha | 4 | 59 | 20 | 0 | 39 | 89 |
8 | Serchhip | 15 | 42 | 40 | 0 | 2 | 92 |
| Mizoram | 186 | 1418 | 1220 | 3 | 195 | 2754 |
7. Programmatic Management of TB Preventive Therapy
Sl. No |
District
| No. of HHC | No. screened for TB | No. put on TB Rx | No eligible for TPT | No. given TPT | % |
1 | Aizawl | 653 | 636 | 0 | 46 | 34 | 74% |
2 | Champhai | 76 | 75 | 0 | 40 | 40 | 100% |
3 | Kolasib | 49 | 49 | 1 | 36 | 36 | 100% |
4 | Lawngtlai | 87 | 82 | 0 | 29 | 29 | 100% |
5 | Lunglei | 27 | 27 | 3 | 19 | 19 | 100% |
6 | Mamit | 70 | 64 | 0 | 33 | 33 | 100% |
7 | Siaha | 54 | 54 | 0 | 37 | 37 | 100% |
8 | Serchhip | 22 | 22 | 0 | 15 | 15 | 100% |
| Mizoram | 1038 | 1009 | 4 | 255 | 243 | 95% |
8. Universal Drug Susceptibility Testing :
S/No. | District | Microbiologically confirmed TB | UDST done | % |
1 | Aizawl | 795 | 723 | 91% |
2 | Champhai | 93 | 81 | 87% |
3 | Kolasib | 117 | 91 | 78% |
4 | Lawngtlai | 90 | 82 | 91% |
5 | Lunglei | 93 | 72 | 77% |
6 | Mamit | 45 | 35 | 78% |
7 | Siaha | 79 | 73 | 92% |
8 | Serchhip | 40 | 39 | 98% |
| MIZORAM | 1352 | 1196 | 88% |
9. TB Mukt Panchayat : Village councils are encouraged to declare their areas TB Free based on the following criteria –
- 30/1000 Presumptive TB testing rate
- <1/1000 population TB case
- 85% Success Rate
- 60% Universal DST
- 100% Ni-kshay Poshan Yojana
- 100% Food Basket coverage
During 2023-24, 14 VC from Kolasib, 11 from Serchhip and 18 from Lunglei were declared TB Free (Total = 43 Village Councils) and felicitated on 24th March 2024, World TB Day
10. Mizoram TB Free Accelerator Initiative : It is a 6 month initiative of NTEP, Piramal Swasthya, Jhpiego, Wadhwani AI and WHO to accelerate TB elimination efforts in the state by-- Vulnerability mapping
- Screening with advanced tools : Ultra portable HH XRay and AI Cough screening
- Upfront NAAT Testing
- TB Preventive Therapy
- Differentiated TB Care Model
As of June 2024, 20 Sensitization programs, 16 Health Camps has been conducted, 1209 number of people have attended the said camps. 1209 number of people have been screened for TB using Cough AI and Hand-Held X Rays.There has been 535 presumptive TB cases out of which 485 number of sputum samples have been collected and awaiting testing with CBNAAT/Truenat for detecting TB. 4 people have been diagnosed with TB.
Achievement during 2022-23
- Total number of presumptive TB cases examined for TB must be higher than 2% of the total OPD attendance. It is assumed that these 2% will be chest symptomatics in any OPD setting. 17315 presumptive TB cases were examined in the year 2022.
- 2081 (1693 public and 388 private) TB cases were notified for TB during 2022. The given targets for TB notification for 2022 were 3000 cases. This is 69% achievement against the target given.
- Success Rate (Cured + treatment completed) of TB patients who had outcomes in 2022 was 87% against a desirable target of 90%
- 100% of all TB patients notified were tested for HIV during 2022.
- 15% of all TB patients tested for HIV tested positive for the same.
- During 2022, 1399 MDR TB cases were tested.
- 117 MDR TB patients were put on some form of Drug Resistant TB treatment.
- The Success Rate (Cured + Treatment Completed) for MDR TB was 73% for Multi Drug Resistant TB patients.
- There was a total of 74 deaths due to TB during 2022.
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Achievement during 2021-22
- During April 2021 to March 2022, 6745 people were examined for TB.
- There were 1698 TB patients notified in Mizoram.
- 1336 patients were notified from Public Sector and 362 from the Private Sector.
- 1694 out of 1698 (99.76%) TB patients were tested for HIV.
- 289 out of 1694 TB patients tested positive for HIV which is 17.06%
- 1670 out of 1698 were screened for Diabetes Mellitus. Screening coverage is 98.58%
- 1660 TB patients were screened for Tobacco usage in smoking and non-smoking form (97.76%) out of which 407 were referred to Tobacco Cessation Clinics.
- 1642 TB patients were also screened for alcohol usage (96.70%)
- Alcohol usage among TB patients is recorded to be 262 among 1698 patients (15.42%)
- 1314 TB patients were also screened for Covid19 during this period (77.38%) out of which 6 (0.45%)
- The Success Rate of TB patients was 90.57% (Cured + Treatment completed)
- TB Preventive Therapy coverage in <5 years is 20.35%
- TB Preventive Therapy coverage in >5 years is 6.20%
- There were 75 deaths due to TB during the same period.
- 2634 patients were tested for MDR TB.
- 109 were diagnosed with MDR TB out of which 106 were put on treatment (97.24%)
- 64.91% of all MDR TB patients had successful outcomes.
Achievement during 2015-2020
Sl;.No. | Indicator | 2015 | 2016 | 2017 | 2018 | 2019 | 2020 |
1 | Total No. of patients examined (Target = 2%) | 9658 | 8961 | 8129 | 8394 | 17171 | 11756 |
2 | Total TB cases notified (Target=100%) | 2088 | 2149 | 2508 | 2601 | 2999 | 2296/4000 (57.40%) |
3 | Success Rate (Ttarget=90%) | 85% | 86% | 88% | 85% | 93% | 78% |
4 | % of TB tested for HIV | 80% | 81% | 90% | 92% | 86% | 91% |
5 | Total TB Patients Positive for HIV | 12% | 12% | 7% | 12% | 14% | 13% |
6 | No. of MDR TB tested | 442 | 1104 | 2568 | 5832 | 6393 | 7112 |
7 | No. of MDR TB put on treatment | 47 | 45 | 68 | 69 | 128 | 166/166 (100%) |
8 | Success rate of MDR TB Patients | 71% | 47% | 25% | 68% | 64% | 72% |
9 | No. of TB death | 38 | 35 | 29 | 51 | 56 | 50 |
