The Revised National Tuberculosis Control Programme (RNTCP) is being implemented following the World Health Organization (WHO)-recommended

Directly Observed Treatment Short Course (DOTS) strategy that provides a sure cure for tuberculosis (TB) with 6-8 months course and is available free of cost to patients in the entire country. Indias DOTS programme is the largest in the world in terms of patients initiated on treatment, placing on an average of more than 1, 25,000 patients on treatment every month.
After achieving global objectives of new case-detection (70 per cent) and treatment success rate of 85 per cent for three consecutive years, RNTCP has announced its new objective of universal access to quality TB care for all TB patients on the occasion of World TB Day. The intermediate target is to detect 90 per cent of all TB cases and successfully treat 90 per cent of them by 2015.

This marks a change in focus from treatment under the previous benchmark. Under universal access, all TB patients in the community, including vulnerable and marginalised persons, will have access to early, good quality diagnosis and treatment services. The new objective is backed by the launch of a new DOTS logo that will be in use from World TB Day 2011 (March 24). It is a progression of sorts from the previous DOTS logo with the slogan (DOTS: Sure Cure for TB). This message has been given a logical extension and will now have a new slogan of DOTS: Pura Course, Pakka Ilaaj to mark the emphasis on completion of full course of treatment.
RNTCP Launches Cat IV (DOTS Plus) treatment for Multi-Drug Resistant TB Multi-drug resistant Tuberculosis (MDR-TB) is defined as resistance of Mycobacterium tuberculosis to Rifampiocin and Isoniazid, two of the most effective anti-tubercular drugs for treatment of Tuberculosis. Drug resistant tuberculosis has frequently been encountered in India and its presence has been known virtually from the time anti-tubercular drugs were introduced for the treatment of TB. There have been a number of reports on drug resistance in India including state level Drug resistance surveillance (DRS) surveys conducted in Gujarat and Maharashtra. Data from these studies have found MDR-TB levels of about 3% in new cases and 12%-17% in re-treatment cases. Although the level of MDR-TB in the community is low in relation to percentages and proportions it translates into large absolute numbers. To address this issue the Revised National Tuberculosis Control Programme (RNTCP) has initiated the DOTS Plus strategy for appropriate management of MDR TB patients and to prevent the propagation and dissemination of MDR-TB LATEST REVISED RNTCP-

*The number of specimen required for diagnosis of smear positive pulmonary TB is two, with one of them being a morning sputum specimen.

*earlier 3 weeks of cough was necessary, now its of only 2 weeks.. *One specimen positive out of the two is enough to declare a patient as smear positive TB. *RNTCP Launches Cat IV (DOTS Plus) treatment for Multi-Drug * Cat V is for XDR-TB. *Switched to Category V treatment: A Category IV patient who during treatment is identified as an XDR-TB suspect and who is found to have XDR-TB on testing by an NRL, who subsequently has had their Category IV treatment stopped and RNTCP Category V treatment initiated.

Definition:Multi-drug resistant tuberculosis (MDR-TB) is defined as an isolate of M. tuberculosis resistant to at least isoniazid and rifampicin. with or without other anti-tubercular drugs based on DST results from an RNTCP accredited Culture & DST Laboratory. All patients that are identified with MDR-TB and are to be treated with an RNTCP Category IV regimen, Extensively drug-resistant tuberculosis (XDR-TB) is TB showing resistance to at least rifampicin, isoniazid, and any fluoroquinolone, and to at least 1of the 3 following injectable drugs used in anti-TB treatment: capreomycin, kanamycin and amikacin Mono-resistance: A patient whose TB is due to tubercle bacilli that are resistant in vitro to exactly one anti-TB drug in an RNTCP accredited laboratory. Poly-resistance: A patient whose TB is due to tubercle bacilli that are resistant invitro to more than one anti-TB drug, except not both isoniazid and rifampicin in an RNTCP accredited laboratory.

Drug-resistant case: A patient whose TB is due to tubercle bacilli that are resistant in vitro to at least to one anti-TB drug according to accepted laboratory methods in an RNTCP accredited laborator.
*