Chauhan L S
Central TB Division, Ministry of Health and Family Welfare, Government of India, New Delhi 110011.
J Indian Med Assoc. 2007 Apr;105(4):192, 194, 196.
The largest TB control programme in terms of patients treated is India's Revised National Tuberculosis Control Programme (RNTCP). The treatment success of new smear positive TB cases under RNTCP has exceeded the global benchmark of 85%. Also there are some challenges in TB control programme eg, addressing TB in HIV-infected persons and accurate diagnosis and management of multidrug resistant TB (MDR-TB). Diagnosis of MDR-TB requires sophisticated laboratories. If MDR-TB is not managed effectively, then there is possibility to emerge drug-resistant TB which is virtually untreatable. The Public-Private mix initiatives of RNTCP attempt to make quality assured treatment for TB for all patients, regardless of healthcare providers they choose. The International Standards of TB Care (ISTC) is an international effort which has articulated the diagnostic, treatment and public health standards which all providers should hold themselves and their peers accountable to. For providers the path to practise the ISTC is to diagnose and treat patients in collaboration with RNTCP. The IMA has taken up the cause of TB control in India very seriously. This organisation of the doctors (IMA) deserves recognition for becoming the first professional association to endorse the ISTC in India. All health providers should work with and support the RNTCP, so that the programme can be made into a genuine mass movement to fight TB.
就接受治疗的患者数量而言,印度的修订版国家结核病控制规划(RNTCP)是最大的结核病控制规划。RNTCP下新涂片阳性结核病病例的治疗成功率已超过85%的全球基准。此外,结核病控制规划还存在一些挑战,例如应对艾滋病毒感染者中的结核病以及耐多药结核病(MDR-TB)的准确诊断和管理。耐多药结核病的诊断需要先进的实验室。如果耐多药结核病得不到有效管理,那么就有可能出现几乎无法治疗的耐药结核病。RNTCP的公私合作举措试图为所有患者提供有质量保证的结核病治疗,无论他们选择何种医疗服务提供者。《国际结核病防治标准》(ISTC)是一项国际努力,它明确了所有提供者应使其自身及同行负责的诊断、治疗和公共卫生标准。对于提供者来说,践行ISTC的途径是与RNTCP合作诊断和治疗患者。印度医学协会(IMA)非常认真地对待印度的结核病控制事业。这个医生组织(IMA)成为印度第一个认可ISTC的专业协会,值得认可。所有医疗服务提供者都应与RNTCP合作并提供支持,以便该规划能够成为一场真正的抗击结核病的群众运动。