Thursday, October 28, 2021
Saturday, July 24, 2021
NI-KSHAY-(Ni=End, Kshay=TB) is the web enabled patient management system for TB control under the National Tuberculosis Elimination Programme (NTEP). It is developed and maintained by the Central TB Division (CTD), Ministry of Health and Family Welfare, Government of India, in collaboration with the National Informatics Centre (NIC), and the World Health Organization Country office for India.
Nikshay is used by health functionaries at various levels across the country both in the public and private sector, to register cases under their care, order various types of tests from Labs across the country, record treatment details, monitor treatment adherence and to transfer cases between care providers. It also functions as the National TB Surveillance System and enables reporting of various surveillance data to the Government of India.
Friday, July 23, 2021
Nikshay aushadhi introduction
Nikshay Aushadhi Mobile App (updated version 1.2.9) is available to download from Google Play Store.
APPLICATION FEATURES
Alert Management
A utility purposed to broadcast information, managing event based and job based alerts and governing the pending tasks as soon as user login into system.
Digital Signature
Eliminating the possibility of human error, assuring security and improving the legal weight by signing documents digitally.
Data Analysis
Tracking the present actions or going on; rather rational analysis of past and present data to approach a better future predictions.
Dynamic Reports
Dynamic reports with its irresolute formats proved to be beneficial handling dynamic data.
Introduction
National Tuberculosis Elimination Program(NTEP) aims for achieving universal access to TB diagnosis and treatment. Over the years, the programme has expended its service of TB and drug resistant TB across the country with access to free diagnosis and anti-TB drugs. The programme is now striving to achieve standards for Tb care in India across all sectors of health care providers.
The National Strategic Plan (NSP) sets out the strategic direction and key initiatives that the Ministry of Health and Family Welfare will undertake from 2017 to 2025 for working towards achieving the goals of eliminating TB by 2025. We have seen excellent commitment and the progress achieved through the previous NSP period, yet much more is required to be done to accelerate the march towards a TB free India.
Continuous and smooth supply of good quality assured Anti TB Drugs and all related commodities is an essential activity under NTEP. The procurement of Anti TB drugs, equipment and diagnostics is planned, coordinated and done centrally on an annual basis through a well-defined procurement mechanism.
National Tuberculosis Elimination Program(NTEP) aims for achieving universal access to TB diagnosis and treatment. Over the years, the programme has expended its service of TB and drug resistant TB across the country with access to free diagnosis and anti-TB drugs. The programme is now striving to achieve standards for Tb care in India across all sectors of health care providers.
The National Strategic Plan (NSP) sets out the strategic direction and key initiatives that the Ministry of Health and Family Welfare will undertake from 2017 to 2025 for working towards achieving the goals of eliminating TB by 2025. We have seen excellent commitment and the progress achieved through the previous NSP period, yet much more is required to be done to accelerate the march towards a TB free India.
Continuous and smooth supply of good quality assured Anti TB Drugs and all related commodities is an essential activity under NTEP. The procurement of Anti TB drugs, equipment and diagnostics is planned, coordinated and done centrally on an annual basis through a well-defined procurement mechanism.
Several initiatives have been taken to enable uninterrupted supply of good quality diagnostics and anti TB drugs to all TB patients. 2500 LED microscopes were procured, along with 1235 CBNAAT machines and 7.8 lakhs cartridges to expand the reach of quality diagnostics across the country and strengthen district level diagnostic capacities.
To enhance the implementation of Nikshay Aushadhi, NIKSHAY and other related activities under NTEP, the Programme has successfully finalized the procurement of 20K of Tablets. The Tablet Computers will be distributed at Central and State levels like Programme & GMSDs officials, State TB Officer, State /Districts Pharmacists, Lab technician etc.
To support states for undertaking Active Case Finding for diagnosis of TB Patients and to fulfill the gaps in diagnostics related to access under the diagnostics policy of NTEP, Programme has procured 45 Medical Mobile Vans. The Mobile Vans have CBNAAT Machine installed on the van itself to facilitate early diagnosis of MDR-TB and TB in high risk population through Active Case Finding. Apart from CB-NAAT machine, vans are fitted with Gen-set, Refrigerator, UPS, Printer, Air Conditioner etc to meet the requirement of CB-NAAT machines.
The programme has now implemented a logistics and supply chain management solution called the Nikshay Aushadhi to enable real time visibility into stock status at all levels and enable forecasting, quantification & further distribution of TB drugs and diagnostics. A synopsis of all related activities pertaining to drug management is now available to all the stakeholders in just a click.
The expansion of diagnosis and treatment services with newer tools and strategies to private sector will be the key to achieve our success of reaching everyone. Let us all pledge and join hands to end TB in India by 2025.
OUR SERVICES
Procurement and Supply Chain Management
It is a Centralised Activity being undertaken by PSM Unit through Procurement Agency selected by MoHFW at Central TB Division. Programme also undertakes direct Procurements particularly of Services and sometime of goods.
Sheffali Sharma
CTD Consultant
Social support
The following schemes are applicable for various beneficiaries under National TB Elimination Programme and are provided as Direct Benefit Transfer (DBT) to the beneficiary:
Nikshay Poshan Yojana
Under this scheme, financial incentive of 500 INR/month for nutritional support is being provided to all TB patients notified under the programme in public and private sector, for the entire duration of treatment.
Transportation support for Patients in Tribal/hilly/difficult areas
TB patient in a notified Tribal/hilly/difficult area is eligible for 750 INR to cover travel costs of patient and attendant at the time of notification.
Honorarium to Treatment Supporter
To be disbursed upon completion or cure of TB patients. For Drug Sensitive TB patients, INR 1000 per TB patient is being provided. Similarly, for Drug Resistant TB patients, INR 5000 per TB patient, wherein 2000 INR for Intensive Phase and 3000 INR for Continuation phase is provided.
Informant Incentive for notification
An incentive of Rs 500 will be provided to any informant who refers presumptive TB cases to the public sector health facility and gets diagnosed as TB
Private provider incentive
Incentive of 1000 INR provided to Private providers for notification and reporting of treatment outcome. It is paid in 2 installments - 500 INR at notification and 500 INR on reporting treatment outcome.
Information on tuberculosis
TB is of two types- Pulmonary and Extra pulmonary.
Only microbiologically confirmed pulmonary TB patients are infectious.
Patients can suffer from both pulmonary and extra-pulmonary TB simultaneously.
TB is not a hereditary disease
Symptoms of TB are specific to the site affected although there are some symptoms common to all types of TB
Symptoms of Pulmonary TB are:
Symptoms of Extra Pulmonary TB depend on the site/organ involved.
Common symptoms:
Tuberculosis is diagnosed by demonstrating TB bacteria in clinical specimen taken from the patient. While other investigations may strongly suggest tuberculosis as the diagnosis, they cannot confirm it.
TB is completely curable if the prescribed drugs are taken regularly for the full duration.
TB is treated through a combination of following drugs:
Combination of drugs is administered to kill all the bacteria and prevent them from becoming resistant to one or more drugs.
The treatment is given for 6-9 months.
Very few people develop side-effects to anti TB drugs.
MDR TB is diagnosed through a special test called culture and drug susceptibility testing (C & DST) which can be performed by some specialized laboratories.
RNTCP or the Revised National Tuberculosis Control Program is the Tuberculosis Control Initiative of the Government of India.
Under NTEP the treatment is available free of cost at all government and identified private and NGO health facilities called as treatment centres. There are about 4 lakh such centres in the country.
The only criteria for becoming a treatment provider is that he/she should be acceptable to the patient and accountable to the health system.
The identified treatment providers are given adequate training on administration of drugs, identification of adverse reactions, follow up and retrieval of the patient in case of treatment interruption.
Treatment providers include
Symptoms of Tuberculosis
Are you experiencing any of the following symptoms?
Fever for more than 2 weeks
Coughing for more than 2 weeks
Coughing up blood
Night Sweats
Unexplained Weight Loss
Side effects
Important Information :
- Not Everyone suffers from Unpleasant Side Effects.
- If you get side effects, mild ones will disappear with time. If you continue to experience unpleasant feelings or side effects, please inform your Treatment supporter, ASHA, ANM or doctor.
- Early action prevents side effects.
- Irregular and inappropriate TB treatment makes you prone to develop Drug Resistant TB
- Don't Share your Drugs or advice treatment to others.
- Don't Smoke or Drink alcohol as it can worsen the side effects.
- Always carry your TB Patient-ID card with you.
List Of Side Effects
- Take medicines embedded in banana
- Do not take all the medicines together
- Take medicines with little water or milk at bed time
- Avoid smoking and drinking alcohol
- Stay hydrated (drink enough water)
- Eat nutritious food
- Eat nutritious food
- Do not stop or reduce the dose of anti-TB medicines on your own
- Inform your Treatment Supporter, healthcare worker or doctor without any delay
- May indicate harm to liver
- Inform and consult your Treatment Supporter, healthcare worker or doctor
- Can be prevented by taking vitamin B6 on doctor's advice
- Usually mild and subsides on its own
- May be due to flu infection.Inform and consult your Treatment Supporter, healthcare worker or doctor
- Apply moisturizing cream
- Do not expose rashes to sunlight
- Rashes usually subside with time
- If rash develops in the mouth or nose or involves very large body area or is associated with fever;inform and consult your Treatment Supporter, healthcare worker or doctor immediately
- Inform and consult your Treatment Supporter, healthcare worker or doctor immediately
- Usually resolves on stopping Ethambutol
- If Ethambutol is stopped, it needs to be replaced by another drug to fully treat TB
- Usually harmless', 'Can be treated with pain killers
- Inform and consult your Treatment Supporter, healthcare worker or doctor immediately'
- Inform and consult your Treatment Supporter, healthcare worker or doctor
- Inform and consult your Treatment Supporter, healthcare worker or doctor
- Needs to be evaluated and can be treated with nutritious food and appropriate drugs
- Inform and consult your Treatment Supporter, healthcare worker or doctor immediately
Nutrition Advice
Nutritional assessment, counseling and support are integral parts of TB care. Undernutrition is an established risk factor for progression of latent TB infection to active TB, increases the risk of severe disease, death, drug toxicity, drug malabsorption & relapse after cure. Moreover, TB leads to weight loss, wasting and worsening of nutritional status. Therefore, Undernutrition and tuberculosis (TB) have a bidirectional relationship.
No single food group contains all nutrients. Not all foods in the same group have the same nutritive value. a balanced diet therefore combines different food groups and different types of foods. Encourage intake of locally available cereals, millets, pulses, nuts, fruits and green leafy vegetables, dairy products, fish and flesh foods (if culturally acceptable).
Nutritional Value Of Common Foods
Cereals and millets
Cereals include rice, wheat and maize and millets include sorghum (jowar), pearl millet (bajra), finger millet (ragi), etc. Use foods containing whole grains as much as possible.
- Nutritive value : Main source of energy: about 350 kcal per 100 gm on an average. They also provide proteins, ranging from 7 gm to 12 gm %, B vitamins, fiber and potassium. Cereal proteins are deficient in some amino acids and combining them with pulses can help provide a good quality protein for vegetarians.
- Special mention : Pearl millet (Bajra) has higher fat content. Finger millet (Ragi) is rich in calcium and a good source of iron.
Pulses
The common pulses are Bengal gram (chana), red gram (tuvar/arhar), green gram (mung), black gram (urad), lentils (masur) and soya bean.
- Nutritive value : They are high in protein (20 to 25 gm %.) and of special value to vegetarians.
- Special mention : Germination of pulses(sprouting) improves nutritive value and can decrease cooking time. Soya bean has 20% fat and up to 37% protein making it a high calorie and high protein food.
Nuts and oil seeds
These include groundnuts, coconut, mustard seeds, sesame seeds, cashew nut, almonds, sunflower seeds and many others from which cooking oil is extracted.
- Nutritive value : Contain high amount of fats(40-60%) and proteins (absent when oil is extracted). Excellent as an energy and protein rich snack for patients with undernutrition. Of special value to vegetarians as a source of protein.
- Special mention : Groundnuts are as good as costlier forms of nuts, but should preferably be taken in a roasted and a deskinned form to reduce the risks due to contamination. Some persons may be allergic to nuts and these should be then avoided.
Vegetables
Vegetables include leafy vegetables, roots and tubers (e.g. potatoes), other vegetables such as gourds, brinjal, tomatoes,beans, peas, cauliflowers, onions, etc. They can be taken generously in diet and seasonal vegetables should be eaten as much as possible.
- Nutritive value : They contain carbohydrates (content varies from 4-25%), and are protective foods and good sources of vitamins A and C, folate, iron and magnesium, fibre.
- Special mention : Green leafy vegetables like spinach, amaranth, fenugreek are high in fibre Vitamin A and C, calcium and iron. Potatoes are energy rich & a good source of vitamin C.
Fruits
Fruits include Bananas, mango, papaya, guava, citrus fruits (including lemon, oranges), melons, apples and pears, berries.
- Nutritive value : Fruits are good source of vitamins A and C and potassium.
- Special mention : Bananas are a good source of energy (about 100 kcal per banana), magnesium and potassium (deficient in patients with severe undernutrition). Gooseberry and guavas have high vitamin C content, while all yellow fruits are good sources of vitamin A (low levels are seen in TB patients, while low levels in household contacts might increase TB risk).
Milk and dairy products
These include milk, curds, cottage cheese (paneer), processed cheese.
- Nutritive value : They are a source of protein, fat, calcium, vitamins A and D, B vitamins (including B12). Depending on the source (human, buffalo, goat), the protein content ranges from 3-4 gm per 100 gm, fat content is 4 – 8%. Protein, fat content of cheese is higher. 100 ml of milk provides 70 to 110 kcal.
- Special mention : Some persons have lactose intolerance and may have flatulence and diarrhoea after consumption of milk and dairy products.
Eggs, Fish, Poultry and Meat
These include milk, curds, cottage cheese (paneer), processed cheese.
- Nutritive value : One egg weighing about 60 gm provides 6 gm of proteins, 6 gm of fat and supplies about 90 kcal. Meat and fish have 15 – 25% protein of good quality, iron and zinc. Fish fat is rich in unsaturated fatty acids and Vitamin A and D.
- Special mention : Egg protein is of high biological value and is the reference protein to which proteins (plant, meat, fish) are compared. One egg can substitute for 50% of pulse consumption in terms of protein intake.
