Elaya Bharatham Seva Trust

Chennai Service Centre

Tuberculosis Control Services

(Public-Private Partnership Model)

Necessity of Tuberculosis Control Services:

Tuberculosis is a major public health problem in India. India accounts for nearly one
third of global disease burden. Tuberculosis is a highly infectious bacterial disease.
One sputum Positive patients, if left untreated infects at least 10-15 persons in a year.
Two persons die due to TB for every three minutes in India; Nearly 3 Lakh School
going children drops school because their parents got TB, nearly one lakh women
deserted by their family because of TB. TB in not only health problem, it is social and
economic problem.

Though Effective treatment is available, due to long duration of treatment

(6-9 months) and prohibitive cost of the drugs, patients fail to take full course of
treatment. Lack of proper health education, guidance and some other reasons, patients
take treatment irregularly which is leading to Multi Drug Resistance (MDR) /
extensively Drug Resistance (XDR) TB which is very difficult to cure.

Service Area and Infrastructure Available

The service area compromises, Alandur, Adambakkam, Ulagaram, Pulizhivakkam,

Nanganallur and Madipakkam. EBST established good rapport with most of private
hospitals, Clinics and with Indian Medical Association of Local branch.

Objective of the Service

• To up lift the poor TB patients by curing the TB,
• Providing TB treatment to HIV-TB patients ,
• Stop the spread of TB in the community by finding sputum positive patients
and curing them,
• To educate the community of TB and reduce social stigma associated with TB
• Involve community ( private medical officers, hospital staff, opinion makers,
community leaders, , Indian Medical Association , etc) in TB control services
Methodology
• Providing free screening of TB to the patients referred by the medical officer
(private/Public)
• Educate and motivate the patient (and their family members) about TB and
importance of taking regular treatment
• Make home visit and provide necessary confidence to the patient and their
family members,
• Provide free treatment under Directly Observed Treatment-short Course
(DOTS) at the place (hospital) and time convenient to the patient
• Ensure follow-up examination till patient is cured.
• Provide Profplex treatment to the children (less than six years of age) of the
positive TB patients to prevent TB to the children due to regular contact.
• Conduct training on sputum microscopy to Private Laboratory technicians for
identifying TB patients
• Conduct training on DOTS to paramedical staff of the hospitals.
• periodically conduct public meetings to honour the persons (both medical and
non-medical) who provided selfless services

Achievements
Initially, in 2004 the Services were started in two hospitals, in very short time,
services extended to all most all hospitals in the area, won appreciation from
patients, doctors, government officials responsible for the programme, and
community leaders.
Brief note on this is enclosed.

Basic data on Patients treated by EBST

SEX
Years F M Total
0-14 4 4 8
15-24 34 32 66
25-34 28 32 60
35-44 18 31 49
45-54 21 29 50
Above 55 21 32 53
total 126 160 286

Disease
Classification SEX
F M Total
Extra-Pulmonary 61 34 95
Pulmonary 65 126 191
126 160 286
 Occupation Female Male Total
Daily wage earners 4 44 48
Home makers 75 0 75
Motor drivers/Mechanics 0 15 15
Skilled workers * 10 29 39
small business/ vendors 1 8 9
Sr Citizens 8 16 24
Students 22 14 36
white color job** 6 32 38
child 0 2 2
Total 126 160 286
*Painters, Carpenter, Musicians, Artisans, Electricians

** Lawyers, Teachers, Clerks,(not involving physical work)

No of
AREA Patients
Adambakkam 123
Alandur 16
Chitlapakkam 2
Egathangal 1
Guindy 3
Kelkattalai 5
kovilambakkam 10
Madipakkam 19
Muvvarrasanpet 3
Nanganallur 52
Nanmangalam 2
Pallavanthangal 16
Pallavaram 1
Puzhlithivakkam 5
Ramapuram 1
Sholinganallur 1
Trisulam 4
Ulagarm 16
Vanampet 1
Velacherry 5
Total 286

Treatment out come No. of Patients

Cured 212(74%)
Defaulted 26(9%)
Died during Treatment 6(2%)
Treatment Failure 2(1%)
Still on treatment 40(14%)
Total 286
Future Programme

Due the success of this programme in the area the demand for the treatment
Programme is increasing. To meet the expectations, there is an urgent need to extend
and consolidate the services in the area.

To expand and consolidate the services in the area, the following steps are to taken.
• To educate public about TB and Availability of Free treatment for TB,
awareness programmes should conducted and sign boards in public places
should be placed.
• To minimise defaulter rate, frequent patient’s house visits should be
undertaken to re motivate the patients for taking treatment regularly.
Appointment of one field worker for each area of service is necessary to keep
track of patients.
• Medicines to minimise drug reaction should supplied to the poor patients to
minimise defaulter rate due to drug reactions
• Wide publicity should be given among private medical practitioners for
increasing the patients referral
• Regular training programme for paramedical staff ( due to turn of staff) should
be conducted to maintain the quality of sputum microscopy and DOTS
programme
• One laboratory with good quality microscope may be established and
qualified laboratory technicians should appointed to keep track of quality of
microscopy among private hospitals and conducting sputum microscopy
training
• Latest technique of sputum of sputum microscopy (CPC deposit method)
should be undertaken to increase improve the yield of positivity in sputum
microscopy