The Provincial Tuberculosis Control Program is struggling to detect, treat and cure infectious TB patients. For this purpose primary healthcare services are involved and necessary diagnostic and treatment facilities are made available free of cost at all level of healthcare facilities and private GP’s and Hospitals.

Program has Organised treatment delivery as close to patient`s home as possible to Minimize Access Barriers through 644 TB treatment centers.

The Program has started Mandatory Contact Tracing. Contacts are being investigated with symptoms enquiry, BCG vaccination status, TST and/or IGRA, and Chest X-ray.

Active tuberculosis will develop in approximately 6% of individual with latent TB infection who are not given preventive therapy. 60 to 70% case reduction rate attributable to preventive therapy. To achieve this Program has started Post exposure therapy.

The program is providing diagnostic facilities at diagnostic facilities 644 Basic Management Units all over Punjab including Tertiary Care, District Head Quarter, Tehsil Head Quarter Hospitals and Rural Health Centers where labs have been upgraded for microscopy including LED/FM Microscopy and logistic support. Evan Solar Panels have been provided for un-interrupted supply of electricity.

160 Gene Xpert Machines have been installed at Tertiary Care, District Head Quarter, Tehsil Head Quarter Hospitals and Rural Health Centers where the test is provided free of cost (market price Rs. 4000). Ten more machines are in process of installation.

READ MORE: Clear negligence

Gene Xpert test is highly advances and sensitive test for diagnosis of Drug Sensitive and Drug Resistant TB. 36 Intermediate Labs one in each district have been established. Four Culture Labs have been established: one each in Lahore, Faisalabad, Sialkot, Bahawalpur have established and one more in Sargodha is being established.

Program is screening High Risk Population (Children, patients suffering from HIV, Diabetes and COPD), Public Hospitals (Medical OPDs), Prisons, Work places through Mobile Vans.PTP is engaged in strengthening cooperation and coordination between all those involved in TB care and management like Non-Government Organizations, Para-statal hospitals: WAPDA, Railways, PESSI etc, large private Hospitals and Professional societies.

Surveillance and Monitoring initiatives by the program is  Effective Drug Supply and Managements System (TB-DMIS), TB Notifiable Android App, Screening Camps Management, Monitoring and Evaluation Application, Gene Xpert Complaint (MIS) Management Information System, District TB Coordinator (DTC / Focal Person TB) App and TB EMR (Case Based System TB-03).

Program has developed training curriculum and conducting trainings of all staff involved in TB-DOTS Doctors for improving TB diagnostic and treatment capacity and quality established. The Provincial TB Reference Labs in Lahore and Multan are efficiently working for drug sensitivity testing and training of Lab staff of the province. In Lahore the Provincial Reference Lab is upgraded and providing Drug Sensitivity Testing (DST) and TB screening on broader indication like risk population and clinical risk groups, Paramedical staff (DOTS facilitator) on recording and reporting, Laboratory personals on AFB staining, Gene-Xpert, culture techniques and DST, Lady health workers early case detection and contact tracing, Store keepers drug managements and store handling and Data operators on MIS, DIMS.

The Program managed a prompt evaluation of a case of presumptive pulmonary TB through Trainings and CME (continued medical education programs) of medical and paramedical staff of Health Department in the Province facility.

The WHO DOTS Strategy is being most effective in curing TB patients is Implemented at all TB care facilities and Case Holding Strategies like TB-MIS registration & follow-up System “TB-SMS Auto Alert System, Follow up Home Visits by LHW,Referral and Notification System “Hospital DOTS Linkage” to improve case holding and effective Monitoring by the program is being implemented in Punjab.

Treatment and management of multi drug resistant (MDR)-TB is expensive, prolonged and associated with multiple adverse effects of drugs contributing to poor compliance further increasing prevalence of MDR-TB. In order to combat the menace of MDR-TB, Program has established eleven centers (PMDT-site) for free specialist advice, free supply of second line drugs and providing comprehensive social and psychological support.