National Tuberculosis Elimination Programme

• Introduction :-

Tuberculosis (TB) is a disease caused by bacteria called as Mycobacterium Tuberculosis. It mainly affects lungs but can also affect all parts of body. TB spreads through air. When a person suffering from pulmonary tuberculosis coughs or sneezes, organisms are spread in air through droplets.  As per Guidelines of Central Government, NTEP is being implemented in Maharashtra since 1998-99 in a phased manner. This programme is implemented all over the state since 2003. To implement this programme effectively State TB Society and 80 Districts/City TB Centers have been established.

Hon. Prime Minister has set an ambitious goal of elimination of Tuberculosis in India by 2025.  

 

• Objectives of NTEP :- As Compared to 2015 achieve following by 2025

1) 80% of reduction in TB Incidence

2) 90% reduction in TB Mortality

3) 0% Patient having catastrophic Expenditure

• Achievements:-

Sr.No	Objective	Status As on 2015	Achievement 2024	Target 2025
1	80% of reduction in TB Incidence	208 Per lakh Population per year as per estimated incidence of GoI	153 Per lakh Population per year as per current notification data in Ni-kshay(27% reduction in TB incidence Rate)	42 Per lakh Population
2	90% reduction in TB Mortality*	4.47% TB death rate programme data	3.6% TB Death rate programme data (19% reduction in TB Death rate)	0.5% TB death rate
3	0 Expenditure for TB Patient	–	Provision of free diagnostics / free medicine/ Nutrition support through DBT/Travel support for each patient (Public & private Sector)	Provision of free diagnostics / free medicine/ Nutrition support through DBT/Travel support for each patient (Public & private Sector)

• Infrastructure under NTEP:-

Institutions	Number
State TB Training Demonstration Centers (STDCs) – Nagpur, Pune & Mumbai	3
State Drug Stores – Nagpur, Pune & Mumbai	3
TB Hospitals(1) TB Sanitorium Buldhana,(2) Aundh Chest Hospital,Pune (3) G.G.Rathi TB Hospital, Amarawati (4) Shashikala TB Hospital, Jaysingpur Dist Kolhapur),(5)Shiwari (Mumbai Municipal Corporation)	5
District TB centers	34
City TB centers	22
Mumbai TB centers (ward wise)	24
Total TB Units (TU)	539
Total Designated Microscopy Centers (DMC)	2025
Culture and DST lab ( Including IRL) (Public 6 and Private 7)	13
Nodal DR TB centers	21
Institutions	Number
Handheld X-ray Machine	99
District DR TB centers	42
Mobile X ray van	6
CBNAAT Machine	171
True NAAT Machine	624
NGO working under programme	80
Partners organization	07
Medical college Govt.	31
Medical college Private	32
PPSA Districts/Corp. Under NHM State	80

• • Implementation of NTEP:-
  • Diagnosis:- All TB presumptive cases (Based on Symptoms) are undergone sputum microscope and chest X-ray as basic diagnostic tool and then further process are done as per requirement. Diagnosis of TB is done as per diagnostic protocol under NTEP. New TB Patients diagnosed are tested for drug sensitivity Universal –Drug Susceptibility Test (U-DST) by various methods for e.g. CBNAAT, TRUENAT, Line Probe Assay (LPA),Liquid/Solid culture etc.

Upfront testing by NAAT machines has been started in the state at places where there is NAAT machines availability

• Treatment :- Diagnosed drug sensitive as well as Drug resistant TB patients (DR-TB) are treated as per NTEP guidelines.
• Un-interrupted supply of good quality fixed dose combination drugs as per weight band is provided to TB patients for complete duration free of cost under NTEP.
• Adherence to treatment is monitored by Medical officer of PHI’s under supervision of Tuberculosis Unit.
• Patient if found drug resistant he/she is advised appropriate drug resistant regimen under programme free of cost.

 

• Different Schemes & Activities Under NTEP:-
• Culture & DST laboratories are functioning for diagnosis of DRTB patients. The list of CDST lab under NTEP is as follows- (Govt. & Private)

1. Microbiology Lab at J. J. Hospital, Mumbai
2. Microbiology lab at Mahatma Gandhi institute of medical sciences Sevagram, Wardha.
3. BJ medical college Pune
4. Medical College, Aurangabad
5. GTB Hospital Sewari, Mumbai
6. IRL, State training and demonstration center, Nagpur
7. IRL, State training and demonstration center, Pune
8. E.M. Medical College, Mumbai.
9. Microbiology Lab at Hinduja hospital, Mumbai
10. Super Religare Laboratory, Mumbai
11. Metropolis Lab Mumbai
12. Infexn Laboratory, Thane.
13. Suburban Lab, Mumbai

Each diagnosed TB patient in programme is tested for Rifampicin sensitivity on CBNAAT/Truenat machine. This helps in early detection of DRTB patients. State has 171 CBNAAT sites & 624 Truenat sites allocated across all districts.

Diagnosed drug resistant TB patients are advised appropriate regimen containing various drugs which needs initiation under guidance of Medical Specialists (DRTB committee).

21 Nodal Drug resistant TB (DRTB) centers are established for initiation of treatment to DR TB patients. In addition to these Nodal DR-TB Centres following 42 District DR TB canters are established where conventional MDR treatment could be initiated at district level to make the treatment services accessible to patients.

  

• Sub-National Certification(SNC):-

Government of India has set an ambitious goal to achieve Ending Tuberculosis (TB), by reducing the incidence of new TB cases by 80% by 2025, five years ahead of global SDG timelines. Conventionally, there is precedence to award certification of elimination of the diseases only at national level, largely led by the World Health Organization (WHO). In this prestigious process Maharashtra got the highest nomination & awards in this TB Free Sub-national Certification. Maharashtra got 2 Silver Medals & 7 Bronze Medals in this prestigious Certification in 2020-21.

 

• Pradhan Mantri TB Mukt Bharat Abhiyaan (PMTBMBA) :- Pradhan Matri TB Mukt Bharat Abhiyan is being implemented in Maharashtra state. Under this initiative there are 13570 Ni-kshay Mitra registered and out of which 12993 Nikshay mitra are agreed upon to provide support. 120301 TB patients are consented for nutrition support and 350620 Nutrition Kits are provided to TB patients till Date.
• BCG vaccination :- Central Tuberculosis Department, Ministry of Health and Family Welfare, Government of India, one additional dose of BCG vaccine is being given from 03 September 2024 to five persons above 18 years of age in selected 40 NTEP districts of the state. One additional dose of BCG vaccine has been given to 15,83,141 persons above 18 years of age under the said initiative on 18 March
• TB Mukt Gram Panchayat :- Central Tuberculosis Department, Ministry of Health and Family Welfare, Government of India, TB Free Panchayat Abhiyan is also being implemented in the state. Under this campaign, the state has succeeded in making 2251 gram panchayats TB free in the year 2023 out of the total gram panchayats in the state. A claim has been submitted to the Central Tuberculosis Department, New Delhi that by the end of year 2024, 7402 gram panchayats of the state will be TB free. The said Gram Panchayats are being honored by giving a bronze statue of Mahatma Gandhi and a certificate in the hands of the District Magistrates.

 

• Cy-TB :- A new test (by subcutaneous injection in the arm) developed by the Central Tuberculosis Department is to screen for latent TB infection (under skin of hand) in persons with no symptoms of TB. The State has received 1,39,200 Cy-TB tests through the Central Tuberculosis Department, which will be used to test TB patients’ household members. In this, preventive treatment will be given to the infected persons.

 

• 100 Days Campaign (7 Dec 2024 to 24 Mar 2025) :-
• Goal-

It is a nation-wide campaign to accelerate TB case detection, reduce mortality, and prevent new cases through focused interventions in districts with the highest TB burden in a stratified approach.

• Objectives-
• Find new cases (among vulnerable groups) – Screening with X-ray and upfront NAAT
• Ensure successful management of identified TB cases (existing & new) – saturate services (Bank Seeding, NPY Payment, HIV, Diabetes, nutrition support – PMTBMBA) and implement differentiated care including TB death audit
• Prevent the occurrence of new cases (TB Preventive Therapy (TPT) among household contacts & among vulnerable groups)
• Campaign Districts-
• Districts are identified based on death rate, presumptive examination rate and estimated incidence rate.
• Rural Districts (17), Municipal Corporation Districts (12), Mumbai (24)

 

• 100 Days Campaign Report from 07 December to 24 March 2025:-
• A total of 44,506 Nikshay Shibirs have been organized.
• 61 Lakh people have been screened for Tuberculosis.
• Out of presumptive Tuberculosis cases identified, 4,00,095 people were tested by chest

X-ray examination.

• Out of presumptive Tuberculosis cases identified, sputum samples of 3,05,339 people were tested using NAAT machine for diagnosis of Tuberculosis.
• Out of presumptive Tuberculosis cases identified, sputum samples of 1,90,357 people were examined under microscope for diagnosis of Tuberculosis.
• 42,175 Tuberculosis patients were diagnosed and registered on Nikshay Portal.
• 20,054 food baskets have been distributed to Tuberculosis patients through Nikshay Mitra.
• 68,123 Tuberculosis patients have been provided the benefit of Nikshay Poshan Yojana.

 

Beneficiary:

TB Patients

Benefits:

It is a nation-wide campaign to accelerate TB case detection, reduce mortality, and prevent new cases through focused interventions in districts with the highest TB burden in a stratified approach