TB Control Program

TB Control Program



Introduction:

Provincial TB Control Program Punjab is a vertical program, under administrative control of Primary & Secondary Healthcare Department and directly supervised by the Director General Health Services Punjab. The program was started in 2004 as a project and PC-1 was developed. The Program has been regularized and shifted from development to non-development mode w.e.f. July 2021. 

The estimated incidence of all types of TB cases is 259/100,000 population. The Program works to achieve the commitments made through Sustainable development Goals (SDGs) and the End TB strategy.


Organogram:


Vision

TB-free Pakistan with zero deaths.

Mission

End TB epidemic in Pakistan by 2035

Goal 

Achieve universal access to TB diagnosis and treatment in Punjab

Program Focus Areas:

  • Diagnostic, Treatment, Preventive Services 
  • Monitoring & Supervision
  • Capacity Building
  • Advocacy
  • Data Surveillance

Diagnostic Facilities


Microscopy

Gene Xpert

BSL-II Labs

BSL-III Labs

Total

757

171

7

3

Public

560

164

4

3

Private

197

04

1

0

Key Achievements:

  1. TB case detection much improved. Even better than pre-COVID era. 
  • Identification of more than 11000 TB patients through pharmacies which were previously un-notified (finding missing TB cases)
  • Screening of a total of 816,148 people for TB in 2021
  • Registration of 209,477 TB patients in 2021 and provision of free of cost treatment
  • TB Treatment success rate maintained above 94%
  • Registration of 1376 patients with Drug Resistant TB in 2021 and provision of free of cost treatment
  • Drug Resistant TB Treatment success rate (TSR) maintained above 72% (Global TSR 54%).
  1. First inter-sectoral coordination meeting including all vertical programs held in December to develop mechanism for integration and bi-directional patient screening.
  2. Multi-Sectoral Accountability Framework implementation in Hafizabad for engagement of sectors, other than health for Tuberculosis – First time done in Pakistan
  3. Establishment of specialized center in DHQ Gujranwala in 2021 for treatment of Drug Resistant TB
  4. Decentralization of DR-TB Care – initiation at DHQ Khanewal & Vehari in March 2022
  5. Distribution of Insaaf Medicine Cards to TB patients. 
  6. Launching of e-TB mobile application for TB Case notification from pharmacies. 
  7. Development of Provincial Strategic Plan 2020-23
  8. PHC Strengthening workshop for Primary Health facility Doctors, Lady Health Supervisors and School Nutrition Health Supervisors
  9. Introduction of Monthly Meeting with District TB Coordinators through video Link.
  10. Introduction of district Score Care system to gauge district performance. 
  11. Capacity Building of Program Directors DHDC and District TB Coordinators on updated National TB Guidelines
  12. Capacity Building of District Statistical Officers and Data Entry Operators on DHIS-2.
  13. Capacity Building of M&E Officers from districts and Private partners from all over Punjab. 
  14. Training of around 3500 district health professionals (doctors / paramedics / Lab staff) on TB guidelines and Lab diagnostics 
  15. Upgradation of TB Provincial Reference Labs (Lahore & Multan) for COVID-19 testing. 
  16. 06 Biosafety cabinets received from WHO for COVID-19 and TB culture testing. 
  17. Un-interrupted treatment of TB and DR-TB patients in COVID-19 lockdown by doorstep delivery of medicine through TTAs.  
  18. Integration with Vertical Programs i.e. IRMNCH, HCP, PACP – Roadmap for developing Multi Sectoral Accountability Framework.
  19. Collaboration with Pakistan Medical Association, Pakistan academy of Family Physicians etc.

Activities for 2022:

World TB Day 2022 Activities (Tentative)
#EndTBPunjab

 Sr. #

Date

Activity

Location

1

7th March

Seminar Rawalpindi

Rawalpindi

2

7th March

Seminar Bahawalpur

Bahawalpur

3

7th March

Seminar Gujranwala

Gujranwala

4

7th March

Seminar Sahiwal

Sahiwal

5

8th March

Seminar Jhelum

Jhelum

6

8th March

Seminar Gujrat

Gujrat

7

8th March

Seminar

Bahawalnagar

8

8th March

Seminar Pakpattan

Pakpattan

9

9th March

Seminar Chakwal

Chakwal

10

9th March

Seminar Hafizabad

Hafizabad

11

9th March

Seminar Okara

Okara

12

10th March

Seminar Attock

Attock

13

10th March

Seminar Narowal

Narowal

14

10th March

Seminar RY Khan

RY Khan

15

10th March

Seminar Faisalabad

Faisalabad

16

11th March

Seminar Sialkot

Sialkot

17

11th March

Seminar TT Singh

TT Singh

18

12th March

Seminar Sargodha

Sargodha

19

12th March

Seminar

Sheikhupura

20

12th March

Seminar DG Khan

DG Khan

21

12th March

Seminar Chiniot

Chiniot

22

14th March

Seminar Khushab

Khushab

23

14th March

Seminar Nankana

Nankana

24

14th March

Seminar Layyah

Layyah

25

14th March

Seminar Jhnag

Jhang

26

15th March

Seminar Mianwali

Mianwali

27

15th March

Seminar Lahore

Lahore

28

15th March

Seminar

Muzaffargarh

29

16th March

Seminar MB Din

M.B.Din

30

16th March

Seminar Kasur

Kasur

31

16th March

Seminar Rajanpur

Rajanpur

32

17th March

Seminar Multan

Multan

33

17th March

Seminar Vehari

Vehari

34

18th March

Seminar Bhakkar

Bhakkar

35

18th March

Seminar Lodhran

Lodhran

36

18th March

Seminar Khanewal

Khanewal

37

24th March

Walks at CEO Offices

All districts




Key Achievements:

1. TB case detection much improved. Even better than pre-COVID era.

Indicators

Target 2021

Achievements 2021

Target 2022

 (3 Quarters)

Achievements 2022

(3 Quarters)

Screening of people for TB

 

816,148

 

730,254

Registration & treatment of DS-TB patients

236,864

209,477

180,846

194,747

DS-TB Treatment Success rate

92%

93%

93%

93%

Registration & Treatment of DR-TB patients

2520

1376

2598

1442

DR-TB Treatment Success rate

90%

72%

90%

78%

 

2.   First inter-sectoral coordination meeting including all vertical programs held in December to develop mechanism for integration and bi-directional patient screening.

3.      Multi-Sectoral Accountability Framework implementation in Hafizabad for engagement of sectors, other than health for Tuberculosis – First time done in Pakistan

4.      Establishment of specialized center in DHQ Gujranwala in 2021 for treatment of Drug Resistant TB

5.      Decentralization of DR-TB Care – initiation at DHQ Sheikhupura, Khanewal, Vehari & Chakwal in March 2022

6.      Distribution of Insaaf Medicine Cards to TB patients.

7.      Launching of e-TB mobile application for TB Case notification from pharmacies.

8.      Development of Provincial Strategic Plan 2020-23

9.      PHC Strengthening workshop for Primary Health facility Doctors, Lady Health Supervisors and School Nutrition Health Supervisors

10.   Introduction of Monthly Meeting with District TB Coordinators through video Link.

11.   Introduction of district Score Care system to gauge district performance.

12.   Capacity Building of Program Directors DHDC and District TB Coordinators on updated National TB Guidelines

13.   Capacity Building of District Statistical Officers and Data Entry Operators on DHIS-2.

14.   Capacity Building of M&E Officers from districts and Private partners from all over Punjab.

15.   Capacity Building of BHU Doctors, Paramedics, LHS & LHW on presumptive identification and sputum collection in 12 Districts.

16.   02 days Training of Trainers on TB management at Provincial Level (TOT)-DHDC Managers

17.   01 day training on DHIS and EMR

18.   01 days trickle down training on EMR

19.   Training of around 3500 district health professionals (doctors / paramedics / Lab staff) on TB guidelines and Lab diagnostics.

20.   Rider model for transportation from BHUs to RHCs and THQs.

21.   Upgradation of TB Provincial Reference Labs (Lahore & Multan) for COVID-19 testing.

22.   06 Biosafety cabinets received from WHO for COVID-19 and TB culture testing.

23.   Renovation of BSL-III Lab Lahore.

24.   Un-interrupted treatment of TB and DR-TB patients in COVID-19 lockdown by doorstep delivery of medicine through TTAs.  

25.   Integration with Vertical Programs i.e. IRMNCH, HCP, PACP – Roadmap for developing Multi Sectoral Accountability Framework.

26.   Collaboration with Pakistan Medical Association, Pakistan academy of Family Physicians etc.

IEC Material: