The Medical Officer (MO) of the referring health facility initiates TB treatment on receipt of the diagnostic test results. All efforts are made to initiate the treatment at the earliest.
The treatment regimen is decided based on the type of patient and TB (based on drug sensitivity pattern, i.e., drug-sensitive TB or H-mono/ poly resistance, history of adverse drug reaction to anti-TB drugs).
A person affected by TB requires support throughout the course of treatment and beyond that. The support to a TB patient is essential to ensure that s/he completes the treatment without affecting her/his quality of life (QoL). Keeping the patient as the central figure in the continuum of care, and ensuring social and personal circumstances are supportive (not only meeting immediate requirements of medical treatment) is the key to treatment support.
A state-level meeting by the Principal Secretary of Health & Family Welfare with all members must be held to communicate the days of the Active Case Finding (ACF) campaign and take all the necessary actions needed to conduct a successful campaign in the state.
Training for ACF is given in a top to bottom manner as follows:
1. Financial Resources
Microplanning for ACF Campaign
Vulnerability mapping and Microplanning are 2 important activities of Active Case Finding which precede field activities. Vulnerable populations should be mapped and recorded in prescribed formats from health facility level onwards. Mapping data from PHI are consolidated at Block level, those at Block level are consolidated at district level and those at district level are consolidated at state level. Data from mapping formats is used for microplanning. Microplanning forms the basis of field activities. Microplans are also consolidated at subsequent levels.
Field supervision of Active Case Finding (ACF) is needed during both the preparatory phase and the implementation phase. Supervisory teams should be formed at the National, State, District, Block and Peripheral Health Institute (PHI) levels.
Field supervision during the preparatory phase:
The Field Supervisors should:
The ACF campaign has to be reported for documentation, monitoring and evaluating the performance of the activity and guiding the policy decisions.
The various formats used for reporting of performance of Active Case Finding (ACF) activities are as follows:
1. Field activity daily report
Table 1: Format for field activity daily report
Mapping of vulnerable population is a pre-requisite for conducting an efficient ACF campaign. It involves understanding the population characteristics, identifying and enumerating and mapping the target population.
Guidelines for mapping
Active Case Finding (ACF) is a provider-initiated activity with the primary objective of detecting TB cases early by active case finding in targeted groups and to initiate treatment promptly.