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PROJECT REPORT ON 

“DIRECT OBSERVED THERAPY SHORT COURSE”

RURAL HEALTH COMMUNITY


SUBMITTED TO - MADAM KALPANA SANDHU (TUTOR)
ORGANIZED BY - IIIrd YEAR GNM STUDENT (2022-2024)
SCHOOL OF NURSING , SIR GANGA RAM HOSPITAL
INDEX
S.NO CONTENT PAGE NO.
1. ACKNOWLEDGEMENT
2. INTRODUCTION
3. SPECIFIC OBJECTIVE OF THE POSTING
4. ACTIVITY OF PHC PALAM
5. SERVICES PROVIDED BY PHC PALAM
6. PHYSICAL SET UP
7. INTRODUCTION OF THE DOTS
8. ANNEXURE
9. ROLE PLAY
10. PHOTO GALLERY
11. SUGGESTIONS
ACKNOWLEDGEMENT
"Success of an individual is possible when he or she is being
supported by others"
We raise our heart in gratitude to God almighty that has been the guiding force behind all
our efforts.
We wish to express our sincere appreciation and keep sense of gratitude to all those who
help us in accomplishing this task successfully.
It was indeed great pleasure and matter of privilege to work under Mrs. UMA BHALLA
MADAM, Principal of School Of Nursing, Sir Ganga Ram Hospital. We are very thankful for
her valuable suggestions and support in conducting the project.
The project has been undertaken and completed under the guidance of MADAM
KALPANA and MADAM SHILPA (tutor), School of nursing. We eventually are grateful for
inspiring for encouragement and support offered us from the beginning till the end of the
project work study.
It gives us in immense pleasure to acknowledge with our deep sense of regard and
infinite gratitude to MADAM MAHESH (Vice principal) and faculty member, School Of
Nursing for their kind help in providing literature.
We are sincerely thankful to the staff that enthusiastically participated in provided their
cooperation and necessary information to conduct this project.
We are sincerely thankful to those mothers who willingly participated and provided their
cooperation and valuable feedback in community health project on the day of role-play.
INTRODUCTION ABOUT THE POSTING
As part of the curriculum for community health nursing during the month of
January2022, we third year students (group of 38 students) of school of nursing,
Sir Ganga Ram Hospital were posted “ PHC PALAM " for rural health posting for
one month under the guidance of Madam Kalpana Sandhu and Madam Shilpa
Katoch P.H.C PALAM was assigned us for our P.H.C posting
OBJECTIVES OF THE POSTING
1) To get oriented to the physical set up, staffing pattern and routine of
PHC PALAM
2) To learn about the setup and working of different clinics like well baby
clinic, antenatal clinic, family planning clinic, communicable disease
clinic etc.
3) To impart health education to public in clinics and community settings.
4) To learn to collect data through home visiting and develop skills in
doing nursing procedures at home.
5) To develop proficiency in assessing the needs and common problem
prevalent in the community.
6) To learn about the records and reports maintained at the centre.
7) To practice communication skills with rural community
8) To participate in the on-going national health programmes like pulse
polio programme, family welfare programmes etc.
9) To conduct survey of a specific area with the aims of collecting base
line data, assessing the needs and organizing health awareness project.
10) To develop skills in performing various procedures in the PHC PALAM
like antenatal palpations, immunization, Cu-T insertion.
11) To develop skills in rendering effective nursing care in community
health setting.
PHC PALAM 
Round the clock emergency services, indoor facilities, OPD routine checkup,
laboratory services, routine test or stool, urine and blood.

MCH AND RCH SERVICES


→Immunization.
→ Antenatal advices.
→ Postnatal care.
→Safe delivery.
→ Management of childhood disease and gynecological problem.
→ Diagnosis and Treatment of complications.
→ Family welfare services in PP unit.
→MTP (Medical Termination Pregnancy). → Mobile services, health education.
PHC PALAM
PHC PALAM was establish in the year 1957.
Population covered- 1,06,626 excluding towns and slums, land
building, 26 residential quotes (types II, III & IV)

ACTIVITIES OF PHC PALAM


OPD SERVICES-routine check up
LABORATORY SERVICES-routine tests (investigation related to blood, urine,stool etc.)
MCH SERVICES-immunization, antenatal advices and counseling on safe deliveries,
postnatal follow ups, counselling on birth spacing, management of other diseases.
Identification and management of any complication.
Health education services.
Training to medical interns lady hardinge medical college.
Referral services.
EMERGENCY

EMERGENCY
Here we learned about different type of emergency drugs and also came to know how to give
immunization most of the cases in emergency unit were accidental injuries and high grade
fever.
In this department there are following department:
■ Treatment room
Male ward
■ Female ward
Labour room
They provide first aid treatment to them refers the patient to necessary government hospital.
HIV ICTC ROOM
In the HIV unit there's division into 2 rooms one is for counselling and another is for testing
Room no 18-testing room
Room no 25- Counselling room
Pretest counselling
Post test counselling
HIV-Human Immuno Deficiency Virus
AIDS - Acquired Immuno Deficiency Syndrome
There are four main causes :-
1. Multiple sex partner
2. Blood transfusion
3. Infected needles and syringes
4. Mother to the foetus

Pre-test counselling
>Person who came for testing are sent to the counselling room before testing.
> To provide all information about HIV/AIDS and collect data from the patient
and history collected, PID no. is also giving to test
Post-test counseling
If the patient is positive, the counseling provide health education
regarding the balance diet, personal hygiene and take precaution.
And help the person to cope up with situation and line happy and
healthy and prevent spread of HIV/AIDS.
MALARIA UNIT
In room no 28 there is a malaria unit.
Malaria
protozoaisfamily.
a febrile disease, caused by a unicellular parasite or
TREATMENT
1st 3 day - 10 tabs (150mg) i.e, chloroquine
1st or 2nd day - 4 tabs (150mg)
3rd day - 2 tabs (150mg)
PREVENTION
DPT vaccine
BHT (Butylated hydroxytoluene Vaccine)
LAB
Lab is in room no 15 whose incharge is Mrs. Sudesh Dogra (lab technician),
she taught us about the text which are being done, throughout the week
The list of test which are being done in this lab are:-
. Urine routine test
.Bile salt, rigment test
.Pregnancy test.B
Total urine test Hemoglobin test
TLC test
DLC test
ESR test
Blood grouping test
. APTT, PTT test
. Blood sugar test analysis
Test of stool for ova and cyst

CENTRIFUGATION
It is a technique which involves the application force to separate particles from
a solution according to their size, shape, density, viscosity of the medium and
speed.it is done after the urine sample is collected. After this urine is put into
the liquid in the urine from any solid component that may be present such as
blood cell, mineral, crystals and one through view under a microscope for
further investigation. The other test for finding an infection is the who stick test
to find out the level of albumin and ketone in the urine sample.
Different type of medicine available in pharmacy are :- 
Syp. coughmate(100ml) Antiussive
amol (pediatric 600ml) Antipyretic
Syp.Cetrazine (50ml) Antihistamine
Syp. Paracetamol Antipyretic
Tab. Pental Antacid
Tab . Ciprafloxacin antibiotic
Syp. ParacetTab. Deriphyllin bronchodilator
Tab . Atenolol Antihypertensive
Tab. Amlodipine calcium channel
blocker
Tab. Ibuprofen Analgesic
Tab . Metformin hydrochloride Antidiabetic
Tab. Ascorbic Acid Vit. C supplement
Gel Diclofenac Analgesic (topical
application)
Nurse’s responsibilities
To check the physician’s order 
To check the drug expiry 
Before taking from the shelf 
Before preparation of the drug 
Before administer the drug to patient
ANTENATAL CLINIC 
In room no.3 there is ANC Clinic where patient come with different complaint
such as abdominal pain, fever, vomiting with irregular menses.
There I learned about the and of examination of antenatal mother. I also learned
how to check the fetal heart sound.
Activities carried out in this unit:-

Activities carried out in this unit:-


Antenatal registration
Antenatal examination
Health teaching activity
FAMILY WELFARE CLINIC
family welfare clinic is in room no. 4 FAMILY PLANNING METHOD:
1. Temporary method
-> For males - CONDOM
Easy to use
• Protect from sexually transmitted diseases. For females - MALA
White tablet for first 21 days and next 7 days black tablets • Prevent from anemia
Hormonal pills
Consist iron and progesterone takes during menstruation
CHAYA
IMMUNIZATION UNIT
In room no.2 there is immunization unit, in which different vaccines are
given.
METHODS TO STORED VACCINE:-
An injectable polio virus vaccine (IPV) are stored in regional and distinct
vaccine store.
➤ Ice Lined Refrigerator
Ice lined Refrigerator are designated for highly vaccine and blood
bags stored with temperature from+ 2 degree C to +8 degree C.
➤ Deep Freezers
OPV and Rota Virus vaccines are stored in deep freezers. No other
vaccines and diuent are stored in deep freezers, temperature - 16
degree C to 25 degree C.
Always measure and record the temperature of deep freezer twice
in a day.
Keep inner and outer surface clean.
Always keep a thermometer inside the deep freezer.
INVITATION CARD
OBJECTIVES OF GROUP PROJECT
1. To give planned health education to the community with the help of a.v aids.
2. To educate the people regarding family planning.
3. To make the people aware of the methods used for family planning
4. To gain skills and confidence on health talk

PLANNING OF THE PROJECT
A meeting of students was called and in the presence of the teacher discussions on the
specifics for the project were carried. The date and time for the project was finalized on
25th of January 2022 from 10:00 am to 12:00 noon. To perform various functions and
activities for organizing the project, students committee were formed and the
responsibilities for each committee were assigned. The list of different committee is as

follow:
S.NO INCHARGE NAME
1. Coordinator Mrs Kalpana Sandhu
2. Organizing secretory Ms Sanya
3. Role play committe Ms Elina
4. A.V Aids Ms Jiya
5. Invitation Ms Aishwarya
6. Refreshment Ms Priyanka
7. Report Ms Himanshi
->LOCATION OF THE PROJECT
A suitable place for conducting the project in the PHC PALAM was explored
after thorough exploration and subsequent discussion with the team
members the venue were decided as PP Clinic by the student and madam
INVITATION CARD
Invitation cards were made along with the schedule were given
to the principal “Mrs Uma Bhalla ” madam , all the faculty of
school of nursing , in the PHC PALAM , all the people, staff
members including
“ Dr RAJAT” two days prior to the scheduled day for project (skit
and health exihibition)on tuberculosis
AUDIO - VISUAL AIDS
Variety of interesting and colorful audio visual aids depicting
different aspects of Tuberculosis were prepared and the small
skit on impotance of DOT’s was conducted
DIRECTLY OBSERVED
THERAPY
SHORT COURSE 
Introduction  :
India account for 27 percent of the total TB cases in world, according to recently released Global TB 
report 2023 by would Health organisation. 
Tuberculosis is a worldwide, chronic communicable bacterial disease. It is a very Strange discase 
because of its varied clinical presentation, host response, chemotherapeutic response, aetiology, and 
social implication.

It is a very ancient disease and its description has aloo been found in the ancient Buddhist and Chinese
waiting.
About Tuberculosis: 
It is caused by mycobacterium tuberculosis chich is commonly known as "Koch's bacillus" or tubercle 
bacillus on diced Fast Bacillus 

(AFB) discoursed by Dr Robert Koch on 24 tr march in 1880. the day celebrated as would TB Day.) 
The most commonly organ involved in TB is lung but it can involve any organ of the human body. It 
usually affects human in age group of 15 to 59 years, church is the most productive age group.
Because of chich community supers groom economic, Social and health burden
Burden of Disease:
would: it continues to be one of the most important public health
problems worldwide
It infects one third of the words populaƟon at any point of time.
Pre - pandemic TB Previous TB report Present TB report 2023
report 2020 2022
Estimated TB cases 26.4 lakhs 29.6 lakhs 28.2 lakhs

Percentage of global 26% 28% 27%


burden
Mortality 4.36 lakh 4.94 lakhs 3.31 lakhs

Percentage of global 36% 36% 26%


deaths
Drugs resistant TB 1.16 lakhs 1.9 lakhs 1.10 lakhs

percentage of global 27 % 26% 27%


dry resistant TB
1. Mycobacterium tuberculosis is nonmotile, non-spore forming, and eod shaped bacillus
that 
das not produce tokin. 
2. On staining with carbol fushin by Liche Neelsen method they resist decolourisation by
05% 
Sulphuric acid and absolute alcohol for ten minutes. So they are known as acid and Alcohol 
Fast Bacilli, AFB
3. Bacilli are sensiƟve to heat and killed at 60 deg. C in 15 - 80 minutes.
Cultures may be killed by
exposure to direct sun light for 2 hours but bacilli in sputum may remain
alive for 20 - 30 hours.
Bacilli may remain alive in droplet nuclei for 8-10 days. culture remained
viable for 6-8 months
at room temperate and may store for a year in the deep freeze cabinet at -
00 deg. C.
4. It is destroyed by Ɵncture iodine in s minutes and 00% ethanol in 2-10
minutes.
5. During the 24 hours. A paƟent may excrete as much as 4 billion bacilli
in the sputum.
reproduce every 30 minutes 
7. It mainly affects the lung and one bacillus multiples to 4096 bacilli in 12 days and
1310772 in 
17 days enough to produce lung cavity. 
8. mycobacterium tb develops resistant to anƟbioƟcs due to change in its drug sensitivity
and 
virulence

High risk of TB:


1. Close contact with someone who have active Tb.
2. Immuno compromised status (elderly, cancer)
3. Drug abuse and alcoholism.
4. People lacking adequate health care.
5. Pre - existing medical condition (Dm, chronic renal failure).
6. Immigrants from countries with higher incidence of TB.
7. initialization (long term care facilities)
8. living in Substandard condiƟon.
9. occupation (health care workers)
Sign and Symptoms:
Constitutional symptom:
o Anaresia
o low grade fever
o Night sweats
o Fatigue
o weight loss
Pulmonary symptoms
o Dyspnoea
o Non resolving Bronchopneumoni

o chest tightness
o non-productive cough
o mucopurulent sputum with
haematopoiesis
o chest pain
Spine tuberculosis
o local pain
o local tenderness
o stiffness
o spasm of the muscles
o cold abscesses
o gibbous
o prominent spine deformity
Meningitis tuberculosis
o Fever and chills
o mental status changes
o nausea vomiƟng
o Photophobia
o Severe headache
o Stiff neck (meningiƟs)
o Agitation
o bulging fontanelle
o Decreased consciousness
o Poor feeding or irritability in children
o Unusual posture with the head and neck arched backward
Abdominal Tuberculosis
o Abdominal pain
o Diarrhoea
o BloaƟng and
o Unexplained weight loss
o Loss of appetite
o Fatigue and weakness
o Ascites
o Fever and night swea
o Enlarge lymph
o Hepatomegaly
Diagnosis of tuberculosis
1. Clinical evaluation
o Healthcare providers assess symptoms such as persistent cuff weight loss night
sweats
and fever
o They enquire about the patient medical history, travel history and potential exposure
to Tb
2. Tuberculosis skin test (tst) or Mantoux test
o A small amount of tb protein is injected under the skin under direction is absorbed
observed after 48 to 72 hours.
o Positive results indicate exposure to tb but do not distinguish between latent
injection
and active disease
DIRECTLY OBSERVED THERAPY SHORT
COURSE 
INTRODUCTION
Directed observed treatment shortcourse is a programme to help to help cure tuberculosis
It is mainly to meet with client to help with TB medication , and provide support and
education
according to WHO “The most effective way to stop the spread of TB in communities with a
high incidence is by curing it
In 1993 , WHO declared tuberculosis a global emergency and began promoting a
management strategy called directly observed treatment short course [DOTS]

What is DOTS ?
DOTS is a comprehensive strategy recommended by WHO for the detection and cure of
tuberculosis
A trained health care worker or a designated individual provides the prescribes anti -
tuberculosis drugs and watches the patient swallow every dose
Why DOTS ?
Tuberculosis is a leading cause of death due to an infectious agent it is
both preventable and treatable
Globally , there are more cases of tuberculosis today and it affects one
third of the population
In response to this catastrope ,the world health organization ’s global
tuberculosis programme in 1993 declared tubercusis a global
emergency and began a management strategy called DOTS
OBJECTIVE OF DOTS
To ensure adherecence to treatment regimen
To check for side effects of any
To decrease the risk of drug resistance caused incomplete
treatment
To enforce standard protocol for the detection and treatment of
tuberculosis as recommended by WHO
For maintenance of proper recording and monitoring systems
Diagnose is simple and treatment cures over 95% of patient in
clinical trials
HISTORY
The strategy for DOTS was developed by karal styblo of the international
union against TB and Lung disease in 1970s and 80s , in Tanzania
In 1980 styblo defines international union against tuberulosis and lung
disease model to control TB in tanzania
In 1990 world bank asks styblo to create pilot project for china
In 1993 WHO declares TB as global emergency
In the fall of 1994 WHO TB advocacy officer kraig klaudt developed the
name and concept for marketing strategy to brand this complex public
health intervention turning the word ‘DOTS ’upside down to spell “stop”
praed a memorable shorthand that promoted stop TB. Use DOTS !
In 1995 , india’s joint effort to eradicate TB NGO observed that “DOTS
became a clarion call for TB control programmes around the world
On march 19,1997 WHO announced that “DOTS was the biggest health
breakthrough of the decade”
BENEFITS OF DOTS 
It ensures that the patient completes an adequate regimen

It lets the health care worker moniter the patient regularly for
side effects and response to therapy

It helps the health care worker solve problems that might


interrupt treatment
By ensuring the patient became non - infectious sooner

The client is monitered closely for the side effect medications


and supported to work through the side effects appropriately
The client is encouraged and supported to complete requires

TB is treated by two regimen ;

MDR AND XDR


The continuing spread of drug resist tub is one of the most urgent and
difficult challenges fewing global TB control patient who are infected with
strains resistant to isoniazid and rifampicin , called multidrug - resistant
[MDR] TB are practically incurable by standard first line drug treatment
In 2012 , these were approx 4,50,000 new case and 1,70,000 death because
of MDR
Extensively drug resistant [XDR] TB refers to MDR-TB strains that are
resistant to fluoroquilones and second line infectable drug the main causes
of the spread of resistant
TB are weak medical system , amplification of resistance pattern through in
correct treatment transmission in communities and facilities
MDR-TB is preseny is 3.8%of new TB patient and 20% of patient who have
history of treatment
It is estimated that 96.1% of MDR-TB cases worldwide have XDR-TB
TYPES OF DRUG RESISTANT -TB
1. Monoresistance - resistance to one first line anti TB drug only
2. Poly drug resistance :Resistance to more than one first line anti - TB drug other
than both isoniazid and rifampicin
3.Multidrug resistance - resistance to at least both isoniazid and rifampicin
4. rifampicin resistance [RR]: resistance to rifampicin deleted to using phenotypic or
genotypic methods , with or without resistance to other anti-TB drug
5 Extensive drug resistance [XDR]- resistance to any fluoroquinoline and least one of
three second line injectable drugs (capereomycin,konamycin and amikacin], in
addition to multidrug resistance

MDR- Diagnosis of MDR -TB and XDR-TB:


Drug specific testing [DST] is required for the definitive diagnosis of MDR-TB OR XDR
-TB the traditional why to do this is through phenotypic methods
M. tuberculosis is isolated from patient sputum and then tested for growth in the
presence of anti-TB drugs
COMPONENT OF DOTS
DIAGNOSIS AND LABORATORY SUPPORT :
DOTS emphasis accurance and timely diagnosis through
comprehensive laboratory , support various diagnostic method
including sputum smear microscopy and advanced molecuele testing ,
aid in detection of TB by softly identifying cases ,DOTS ensure prompt
initiation of treatment minimizing transmission and improving patient
outcome

.Uninterrupted drug supply


A fundamental aspects of DOTS strategy is the uninterupted
availability of high quality with tuberculosis medication ensuring a
stready of reliable drug is crucial for successful treatment
Robust drug management system strangement availiability control
measure and efficient mechanism work hormonoisly to maintain a
consistent drug supply preventing treatment disruption
STANDARDIZED TREATMENT REGIMEN

DOTS promote standerized treatment regimen which have been designed to optimize effectiveness and minimize the
risk of drug resistance these regimen are based on regional guidelines tailored to address varying epidemiology factor
patient charateristic

SUPPORTIVE SYSTEM AND MONITERING :


DOTS INCORPORATE ROBUST SUPPORTIVE system and machenism to facilitate comprehensivecare for
TB patient these system encompass regular follow up visit psychological support , patient education
maintained of treatment related side effect .Data collection analysis and through health information
system contribute based decision making and program performed assessment

ELEMENT
Government commitment [including partial will let level and establishment of a cantralised priotized system of TB
monitering , recording and training
case detection by sputum smear microscopy
Standardized treatment regimen directly size to 9 month observed by healthcare worker for atleast the first 2 month
Drug supply
Standerized recording and reporting system that allow assessment of treatment result
99 DOTS
99 DOTS is an IIT- enabled ‘pill in hand’ adherence monitoring system
implemented by the national TB eliminated programme [NTEP] for all
drug - sensitive TB [DS-TB] patients on a daily regimen
99 DOTS is an approach for monitering and improving TB medication
aherence among TB/HIV co infected
BENEFITS
99 DOTS is an effective approach for improving TB medication
adherence , thereby increasing the compliance to TB treatment
It will be helpful for easy access of treatment to patients from remote
areas
ADVANTAGES OF 99 DOTS
Enables the NTEP staff to prioritize patients who need to visited to be
visited and counselled
Empowers patient to be able to take change of their own treatment
BACKGROUND
99 DOTS is a low cost , mobile phone based technology that
enables real- time remote monitering of daily intake and
treatment , first introduced by the revised national tuberculosis
programme under the national programme under the national
programme in 2015 in high burden antiretroviral therapy
[ART]centers
This project was launched foe the first time in 2016 in rajkot
district, gujarat, india and hence this was an effort to evaluate 99
DOTS
COLOUR CODING OF DOTS IN TB:
RED DOTS- to mark medications doors for active TB cases

->signifies that the patient is currently undugoing treatment

GREEN DOTS- universal symbol for completion and success in the

content of TB treatment

YELLOW DOTS- used to indicate caution or the need for close

monitering

BLUE DOTS- used for paediatric TB patients


RECORD AND REPORTS
TB REGISTER -
TB register is maintained at the PHC that includes information about each TB patients like
diagnostic information , demographic details etc

TREATMENT CARDS [BLISTER PACKS]


->Individual cards / packs are made to monitor medications adherance
->contain certain color coded dots

DOTS OBSERVATION RECORDS -


Record of directly observed treatment sessions are kept they indicate when and where the
patient received medications under direct observation
REVISED NATIONAL TUBERCULOSIS
CONTROL PROGRAM
India had a National tuberculosis programme [NTP] since 196
2 .A comprehensive review of NTP in 1992 found that NTP had
not achieved is aim on target based on there commendation of
1992 reviews are revised National tuberculosis control
programme [RNTCP] incorporating the component of
intentionally recommended DOTS strategy for control of TB was
developed
OBJECTIVES
->Emphasis on cure of infectious disease and senior ill patients
of TB through administration of supervised short course
chemotherapy , to achieve a cure rate at least 85%
augmentation of case finding activities to detect 70% estimated
cases , only after having achieved the desired cure rate
PHASES OF NATIONAL TB CONTROL
PROGRAMME
PHASE-1 PHASE-2
 PHASE-3 PHASE-4
1997-2006 2006-2011 2012-2017 2017-2025

PHASE 1 :
In 1978 BCG vaccination was shifted under the expanded programme on immunization
a joint review of NTP was done by government of india WHO , swedish international
development agency SIDA in 1992 around same time in 1993 the WHO declared TB as a
global emergency devised the DOTS and recommended to follow it by all countries the
govt. of india revctaised NTP as revised National TB control programme in same year
DOTS was official launched as RNTCP strategy in 1997 and by end of 2005 entire
country was covered under programme
PHASE 2 :
RNTCP improved the quality and reach of services and worked to reach global case
detection and cure target these targets were achieved by 2007-2008 Despite these
achievement undiagnosed and mistreated cases continued to drive the TB epidemic TB
was the leading causes of illness and among person living with HIV aids
PHASES 3:
During this period for achievement of the long ter visio of TB free India , national
strategic plan for TB control 2012-2017 was documented with the goal of universeral
access to availity TB diagnosis and treatment for all TB patient in the community
PHASE 4 : 
To eliminate TB in india by 2025 , five year ahead of the global target , a frame work
to guide the activities of all the stokeholder including the national and state
government development partner civil society organisation , international agencies ,
research institution , private sector , anf others whose worl is relevant TB
eleimination india is formulated by RNTCP National strateguc pean for TB
elimination 2017--2025

NATIONAL STRATEGIC PLAN FOR TUBERCULOSIS
ELIMINATION 2017-2025 :
NSP is an innovative step required to eliminate TB in india by the year 2025 it is a
three year plan and eight year strategy document 
VISION- TB free india with zero deaths, disease and poverty due to TB 
GOAL- to achieve a rapid in burden of TB , morbidity and mortality while working
towards eliminated of TB by 2025 

OBJECTIVES :
To find all drug sensitive TB and drug resistant TB cases
To initiate and sustain all the patients on appropriate anti TB
treatment
To prevent the emergence of TB in suspectible population
To build and strenghthen enabling policies , empowered ,institutions,
additional human resources with enhanced capacities and provide
adequate financial resources

STRATEGIC PILLARS
1. Detect
2.Treat
3.Prevent
4.Build
1. DETECT
Notofication of TB cases
NIKSHAY- A case based web based TB surveillance system for both govt.
and private health care facilities
Public private partnership- Private provides are provided incentives for TB
case notification and for ensuring treatment adherence and treatmet
completion the incentives to private sector TB care praiders are 05 follows
RS 250-on notification of TB case diagnosed as per STCI
RS250- on completion of every month treatment
RS500- on completion of entire course of TB treatment
RS 2750/- for notification and management of a drug sensitive patient over
6-9 months
RS 6750/- for notification and correct management of a drug resistant case
over 24 months

free drug and diagnostic test to TB patient to private sector


TREAT
For new TB cases , treatment in intensive phase [IP] consist of 8 weeks
of isoniazid , rifampicin ,pyrazinamide and ethambutol in daily dose as
per 4 weights band categories and in continuation phase three drugs
rifampicin ,isoniazid and ethambutol are continued for 16 weeks
FOR PREVIOUSLY TREATED CASES OF TB- intensive phase is of 12
weeks , where inj. streptomycin is given for 8 weeks alog with four drugs
[INH ,rifampicin,pyrazamide and ethambutol] and after 8 weeks of four
drug in daily dose as per weight bands and continued for another four
weeks . In continuation phase,rifampicin, INH and ethambutol are
continued for another 20 weeks as daily dose
NIKSHAY POSHAN YOJANA - Financial incentive of Rs 500/- per month
provided for nutritional support to patient on anti- TB treatment
Expending options for ICT based treatment
Intensifying TB control activities
PREVENT
Air borne infection control measure
1.early diagnosis and proper management of TB patient
2. health education about cough etiquettes and proper disposal of
sputum
3. house should be adequatelu ventilated
4.proper use of air borne infection measure

CONTROL TRACING
All close contact
isoniazid preventive therapy
BUILD
Health system strengthening for TB control under the national
strategic plan 2017-2025 is recommended in the form of building
and strenthening enabling policies , empowering institutions and
human resources with enhanced capacities
ROLE PLAY
narrator 1: tabiyat thi inki acchi khaasi, ab rukti nhi hai ye khansi ,
salha dedo koi acchi khasi
Latika 2 - good morning,nameste, sasriakal,aadab hum school of
nursing sir Ganga Ram hospital ke 3 Rd year ke chatra ap sabhi ko
TB ke baren main kuch jankari dene aaye hai jaise ki aap sabhi ko
pata he hai ki pradhan mantri dwara national tuberculosis
elemination programe jari kiya gya hai jiska udeshya 2025 tak tb
mukt bharat hai aj hum uski baat karenge
Himanshi singh 3- tb toh hai bimari purani phir kyu sune hum inki
kahani
Latika 4- niyantrit thi jo yeh bimari ab hone lagi hai isse or
pareshani
Diksha- 5Ha ha ha main hoon tb main khushi toh nahi deta mat
gam bhot deta hoon main ek Saal main lakhon logo ko apni
chapet m le leta hoon ..
Main 80% fefdo ko tatha 20% gurde dimag haddiyan aur aanto ko
prabhavit karta hoon ...
Ek tb ka rogi ek saath 10 se 15 logo ko Sankramit kar sakta hai
Itna hi nahi main har 3 minute main kya suna har 3 minute main 2 logo
ki maut ka Karan Banta hoon ...
Are tum log toh itne murkh ho jo na jaache time se karate h or ma
dawai time se khate ho mere pahele lakshan bukhar or khansi se pta
chal jate the par ab toh unka ka bhi Pata nahi chalta ha ha ha ha ....

Kanishka-6 Tb toh bhaut bhayank bimari lgti hai.lekin ye hoti kesse hai?
Iska hone ka karan kya hai?
Narrator 7 - main batati hu ,main batati hu .
Tb hone ke kehi karan hai .
Phela asantulit ahaar , aasamanya jivanshaili, bheed wala ilaka, mask
na pahenna khule me khasi krna or thukna .
Himanshi singh-08- aur agar kisi ko tb hogya toh uske lakshan ky ky
hoskte hai?
Vanshika - Dhundo ilaj tabyt ko sambhla, tb k symptoms ko dekho aur zindgi ko sawaro.
Raaton mein pasina, din mein bechani tb k symptoms ki hai ek alag hi khani.
Cough aur khaasi ho sakti hai aam, lekin 2hafte se jada khasi
Badan dard
Vjan khatana (weight loss)
Bhukh na lagna (loss of appetite)
Bukhar aana
Chati mein dard
Tb k ho skte hai lakshyan tamaam.
Sneha harichand - To ye hamne lakshan hai jane par TB hai ye kese pehchane
Archana - Tb k bachav k prakar k 4
1.balgum ki jach
2. Chest xray
3.monteux test
4.tb gold
Agar rakhna ho tb ki bimari durr samah rehte karaye jache zarur.
Deepali - Agar tb ho bhi gya toh ilaaj kese karvaye !
Nisha - DOTs centre dega tumko madad Puri TB ke ilaaj ke niyam hai jaruri
dots yani directly observe treatment short course ki sarkar dwara banai gai
ek aisi Yojana hai jiska mukhye uddeshy hai TV per niyantran pana ismein
DOTs karamchari prashikshit admit ya koi bhi namit aadmi apne samne hi tb
rogi toh dawai khilata h taki koi bhi dose miss na ho sath hi har rb rogi ko har
mahine ₹500 diye jate h taki uska aahaar acha ho . Unhe ye btaya jata h
kibapni dawaiyo ko samay se le or apna ilaj ka course pura kre .
..Agar naga hui koi dawaii Samjho bimari wapas ayi
.Har tab rogi ko h batana
6-8mahine dawaiya h khani
Jo krdi koi ana kani
Hogi jane kya kya pareshani
Mansi - dawaiya to le le
Lakin iske prabhawo ko kese jhele
Deepali-Tab ki davaio se ho skti h kuch preshani jese :
Lal rang ka peshab aana
Bhuk na lagna
Ulti hona
aankho ki drishti ka dhundla hona
Aur badan dard hona
Yeh hai sari aam samasya inse na tum ghabaraana
Aur apne ilaaj ko pura krvana
Vanshika- Apno ka kaise dhyaan rkhe
Tab se kaise bachav kare
Deepali-Harr saans maayne rkhta h
Harr saans maayne rkhta h
Ab tab ka rokthaam Krna h
Himanshi- logo ko denge jankari puri is banegi tb se duri
Deepali- Janam ke samay BCG ka tikakaran krnana h zaroori
isse bani rhegi tb se durri
Himanshi - khaste chikte baat krte wqt mask ka istemaal krna h
zruri ..alg h rehna sbse isme, apne or dujo ka dhyan h zruri
Deepali-Acha Khan pan bhi h bhot zaroori
Chinta aur kamzori se aati tb
Sharir na lad paye jab tb se
Agar na ho rokh
pratirodhak shakti hum mai
Archana- Toh rog pratirodhak shakti ko kesse badaye?
Mansi- ratishodhak shamta badahaye
protein se bharpur Khana khaye
Sneha- dal or protein ka Mel hai sehat ka khazana
Mansi- soyabean or mushroom bhi h sth m sehat ka khazana Sneha-
gosh Anda machali bhi sth protein ke sth
Mansi- inko khana se sehat banti aachi khasi
Sneha- dudh or dudh se bani chize h sehat ka pegam
Mansi- chane ka pyar , protein se bhara h ye sehat ka izhar
Sneha-Long adrak lashan halfi m hai gunh kafi
Mansi- aachi sas m madad kre dard ko kam kre khasi m Rahat de kaafi
Sneha- iske sth kuch falon ko lena h jaruri
taki rahe bimariyo se duri
Elina-iske sath sath kre vyayam taki mile sharir ko aaram
Jese ki
Anulom vilom, kapal bhati, trikon asan, or taad asan .
Aese krne se saans ki shamta ko bdaya ja sakta hai
Diksha-Ha ha ha ha ....
Are main tb hoon tb mujhe koi ni hara paya tum kese haraoge ....
Kaise karaoge mujhe tum log na dawai time se khate ho na jaache time se karate ho
are main toh chala jaunga lekin Mera bhai hai na MDR or XDR tumhare saath saath
tumhare gurde or liver ko bhi saath lekar jayega
ha ha ha ha ha ha ..........
Sneha(M)-ham bachayeinge !
Bahoot hui laparwahi ab dikhayenge samajhdaari .
Samay samay par hath dho kr ,
Santulit aahar pakar
Samay PR dawaiyan kha kr
Khanste waqat muh dhak kr or mask pehen kr
Bheed bhad Wale ilake m jyada na jakr or vyayam karke.
Latika- toh jaise ki hum sabhi ne apko bataya ki tb kya hai uske kya karan hai or kya
uska bachav hai toh aj se hum ye pran lete hai na toh khud ko tb hone denge na kisi
ke hone ka karan banenge or national tuberculosis elemination programe main apna
yogdan denge
Kanishka- Hai TB jo jadh se mitana
Apna or apno ka dhyaan
Rakhna Hai desh ko TB mukt
banana Hum sabko ye nara
apna na
THANKYOU
DATA ANALYSIS
TABLE - 01
FREQUENCY ,PERCENTAGE DISTRIBUTION OF DEMOGRAPHIC PROFILE
(n= 100)
S.NO DEMOGRADEMOGRAPHIC FREQUENCY (N)
DATA
1. Age
15-30 36
31-45 31
46-60 20
Above 60 15
2. Gender
Male 50
Female 50
3. Education
Illiterate 26
10th pass 14
12th pass 45
Graduate 10
Post graduate 05
4. Marital status
Married 72
Unmarried 22
Divorced 04
Widow 02
5. Socio economic status
Less than 10,000 26
10,000-20,000 33
20,000-30,000 23
Above 30,000 18
6. Type of diet
Vegeterian 35
Non vegeterian 55
7. Total meals in a day
3 meals 79
2 meals 15
Frequent meals 06

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