Annual Risk of Tuberculosis Infection Among the Tribal Children of Jhabua, Madhya Pradesh.

A cross sectional tuberculin survey was undertaken to estimate the Annual Risk of Tuberculosis Infection (ARTI) amongst tribal children aged 1-9 years in Jhabua district, Madhya Pradesh, India. Of the 1056 test-read children, 774 (73.3 %) had no BCG scar. The prevalence of infection was estimated as 6.3% (95% CI: 4.8-7.7) and ARTI as 1.2 % (95% CI: 0.9-1.5). The findings suggest that the tuberculosis situation in the tribal population of Jhabua district is not that different from the situation among the non-tribal population in the country. However, there is a need to further intensify tuberculosis control measures in the area.

Prevalence of pulmonary tuberculosis amongst thebaigas A primitive tribe of Madhya Pradesh, Central India.

Background: A community-based cross-sectional tuberculosis (TB) disease prevalence survey was undertaken amongst the Baiga primitive tribal community of Baiga Chak in central India. Material and Methods: A population of 2,359 was covered under the study. Sputum samples were collected from chest symptomatics and examined for smear microscopy and culture. Results: Overall prevalence of PTB was 146 (95% C.I: 0 - 318) per 100,000 population. Conclusion: The findings suggest that TB is not a major public health problem amongst this tribal group. However, there is still the need to maintain and further strengthen TB control measures on a sustained and long term basis in the area.

Involvement of Non-allopathic Private Practitioners under DOTS in an urban area of north India.

Background: In an urban area of a north Indian district (population 150,000), nine private practitioners of non-allopathic medicine, including five with no qualification and two private paramedical staff, were trained as per programme guidelines before being involved as treatment observers in the DOTS-based Revised National TB Control Programme and supervised. They were not given any financial incentive. Material and Methods: During 2002, they managed 185 TB patients (85% of the cases in the urban area) and amongst the 63 new smear-positive patients, the cure rate was 84%. Over a 6 month period, 6% of the total new smear-positive patients detected in the area were referred by these private practitioners. Results: Results suggest that non-allopathic practitioners and paramedical staff from the private sector can make a significant contribution to TB control, by increasing case detection and treatment observation.

Health policy, systems and services research and the Revised National Tuberculosis Control Programme.

Directly Observed Treatment, Short-course (DOTS) has become the accepted standard for diagnosis, treatment and monitoring of tuberculosis (TB) worldwide. DOTS is the best treatment strategy available today, but it does not and cannot remain static. Health policy, systems and services research (HPSSR) described in the context of TB control, offers significant gains at relatively low cost and in a shorter timeframe. A rational framework is necessary to develop a research agenda and select priorities, especially when resources are limited. India has adopted, adapted and implemented DOTS strategy as the RNTCP. RNTCP has a clear set of programme objective ie, (a) cure of at least 85% of registered new smear positive pulmonary TB (NSP) cases and (b) detection of at least 70% of estimated NSP cases existing in the community. The RNTCP must be supported by research that continuously provides better tools for diagnosis, treatment and monitoring.