When there is a modification in the Drug-resistant TB (DR-TB) regimen as suggested by the Drug-Resistant Tuberculosis Centre (DR-TBC), the district drug storekeeper/ pharmacist prepares the modified boxes from loose Second-line anti-TB Drugs (SLD) supplied from the State Drug Store (SDS).
The principles of designing Drug-resistant TB (DR-TB) treatment regimens (Shorter or longer oral Multi (M)/ Extensively Drug-resistant TB (XDR-TB), and H mono/ poly DR-TB regimens in children are similar to adults:
Goals of Drug-resistant Tuberculosis (DR-TB) treatment under the National Tuberculosis Elimination Program (NTEP) are as follows:
There are different scenarios regarding patient-wise box (PWB) management. These are described below.
Scenario 1: Modification in regimen
In this scenario, the nodal and district drug-resistant tuberculosis centre (N/DDR-TBC) committee decides on a regimen modification.
The DR-TB drugs are the Second Line Drugs (SLD) prescribed to the TB patients based on resistance pattern. The treatment duration varies from 9-20 months depending on the regimen being administered. These drugs are supplied as monthly Patient Wise Boxes (PWB) of Type A and Type B .The Type A boxes contains drugs that are common in Intensive Phase (IP) and Continuation Phase (CP) and Type B box contains drugs that are given only during the IP.
The Flow of DR-TB Drugs in NTEP
In supply chain management under the National TB Elimination Programme (NTEP), the term receipt refers to the act of receiving anti-tuberculosis drugs and other commodities by the State Drug Stores (SDSs) in response to the requests made by the states.
Expiry management of supplies is crucial to avoid financial losses and harm to patients.
Physical Verification of stock is a two-step process:
Senior Treatment Supervisor (STS) is one of the key programme staff working under NTEP at TU level.
Roles and responsibilities of STS include: