Chauhan L S
Central TB Division, Directorate General of Health Services, New Delhi.
J Indian Med Assoc. 2003 Mar;101(3):152-3.
Tuberculosis has been a public health problem in India since time immemorial. The disease has a devastating socio-economic cost in India, with over 450,000 people dying of TB each year--1000 every day, 1 every minute. To control the menace, Revised National TB Control Programme (RNTCP) was implemented starting in October, 1993. Around 1.6 million TB cases have been placed on treatment under RNTCP since its inception, saving over 290,000 lives. The first and foremost challenge to RNTCP is covering the entire country so that benefits are available to all Indians. Planning for nationwide coverage by 2005 for maintaining high quality of TB services is a major challenge while undertaking a rapid expansion of RNTCP Another challenge is acute shortage of manpower. Decentralisation of programme management for effective administration and sustainability of the programme to the states is another challenge. Other sectors like NGO, private practitioners Railways, ESI scheme, Medical Colleges, health care providers are to be involved in RNTCP. Despite these challenges RNTCP is performing very well. DOTS is the best available strategy for curing TB patients and that all the elements of DOTS must be adopted both in letter and in spirit.
从远古时代起,结核病就是印度的一个公共卫生问题。该疾病在印度造成了巨大的社会经济损失,每年有超过45万人死于结核病——每天1000人,每分钟1人。为了控制这一威胁,1993年10月开始实施修订后的国家结核病控制规划(RNTCP)。自该规划启动以来,已有约160万结核病患者接受治疗,挽救了超过29万人的生命。RNTCP面临的首要挑战是覆盖全国,使所有印度人都能受益。在快速扩大RNTCP的同时,规划到2005年实现全国覆盖以维持高质量的结核病服务是一项重大挑战。另一个挑战是人力严重短缺。将项目管理权力下放给各邦以实现有效管理和项目可持续性是另一项挑战。非政府组织、私人执业者、铁路部门、雇员国家保险计划、医学院、医疗服务提供者等其他部门也应参与RNTCP。尽管存在这些挑战,RNTCP的表现仍然非常出色。直接观察短程治疗(DOTS)是治愈结核病患者的最佳可行策略,必须在字面上和精神上全面采用DOTS的所有要素。