NTEP

ORGANOGRAM
Akhila Sethunath
Roll No.10
 INTRODUCTION
●National Tuberculosis Programme (NTP) –1962.

●Revised National TB Control Programme (RNTCP)-1993

●RNTCP NTEP- 2014

 NTEP ORGANOGRAM

●NTEP structure comprises of five levels: National,

state, district,sub-district and peripheral health
institutution levels.
1.National Level

●Central Tb Division(CTD) manages the National Tb Control

Programme for the entire country at the central level through a
national programme manager,Deputy Director General Tb ( DDG
Tb).

●Financial and administrative control-joint secretary,administrative

arm of MoHFW.
●Supporting facilities include:-

☆National Tb Institute(NTI),Bangalore

☆6 National Reference Laboratories(NRL) including NTI,National Institute for

Research In Tuberculosis(NIRT),Chennai;National Institute of Tuberculosis and
Respiratory diseases(NITRD),Delhi;National Japanese Leprosy Mission for Asia
(JALMA);Institute for Leprosy and other mycobacterial diseases,Agra;Regional
Medical Research Centre,Bhubaneswar and Bhopal Memorial Hospital and
Research Centre(BMHRC).

☆National Task Force for collaboration of medical college activities in the

country.
2)State Level
●State health Society or its equivalent under NHM of the State manages the Tb Control
Programme.

●State TB Cell(STC) has a State Tuberculosis Officer(STO) trained at national level and is
responsible for planning,training,supervising and monitoring the programme in all
districts of their respective states.

●STC is being supported by State Tb Training and Demonstration Centre(STDC) through its
three units-a training unit,supervision and monitoring unit and an Intermediate
Reference Laboratory (IRL)-quality assurance system of sputum smear microscopy
network and laborarory services for PMDT.
●State drug store

☆each 5 crore of population

☆Effective management of medicines and uninterrupted supply of

good quality 1st and 2nd line anti-Tb medicines.
3)District Level
●The Chief District Health Officer(CDHO) / Chief District Medical
Officer (CDMO)/Civil Surgeon is responsible for Tb Control activities
in the district.

●The District Tuberculosis Centre(DTC) is the nodal point for Tb

Control activities in district and is headed by the District Tuberculosis
Officer(DTO) who is assisted by other technical and secretarial staff.
4)Sub-District Level(Tuberculosis
Unit Level
●The Tuberculosis Unit(TU) is the nodal point for Tb Control activities in
the sub-district.

●TU’s are based mainly in the NHM health blocks to align with NHM
Block Programme Management Unit(BPMU) for optimum resource
utilisation and appropriate monitoring.

●TU- 1 per 200000(1.5 -2.5 lakh) population for rural and urban areas; 1 per
100000(0.75-1.25 lakh) population in hilly/tribal/difficult areas.
●The TU consists of a Medical Officer- Tuberculosis Control (MO-TC) and Senior Treatment
Supervisor(STS).

●1 Senior Tb Laboratory Supervisor(STLS)-5 Lakh Population( 1 per 2.5 Lakh Population for
hilly/tribal/difficult areas).

●Additional STS if more than 300 Tb cases are registered in public sector annually in a TU;
if more than 50 private health establishments are registered in NIKSHAY in a TU and more
than 50 private health establishments are registered in NIKSHAY in a TU and if more than
200 Tb patients are notified from private health establishments annually in a TU.
●The TU has one Designated Microscopic Centre for every
100,000 population (50000 in tribal,desert,remote and hilly
regions).
5)Peripheral Health
Institututions(PHI)
●A PHI is a health facility which is manned by atleast a medical officer.

●At this level,there are dispensaries,PHC’s,CHC’s,referral hospitals,major

hospitals,speciality clinics or hospitals(including other health facilities),TB hospitals,
ART Centres and medical colleges within the respective district.

●All health facilities in the private and NGO sectors participating in NTEP are also
considered PHI’s by this programme.
●Peripheral Health Institututions undertake tuberculosis case-
finding and treatment activities.

●There is 1 Tb health visitor(TBHV) per one lakh urban

population to support the urban Tb control activities.
 TB Laboratory Services

●The laboratory network under NTEP is a 3-tier system for provision of diagnostic services
and maintaining its quality.

A]The peripheral laboratories are situated in the public sector like the dispensaries,
PHC’s,CHC’s,referral hospitals,major hospitals,speciality clinics/other sector hospitals/
Tb hospitals/medical colleges and in the private/NGO sectors.
B]At the state level-Intermediate Reference Laboratory (IRL) situated in STDC/medical
college/public health laboratory.

☆27 IRL’s with facilities for culture and DST.

☆CBNAAT sites:To diagnose Rifampicin resistance among all Tb patients;established

in DTCs,Tb units and medical colleges.
☆DRTB Centres:Clinical management of drug resistant Tb.

●Nodal DRTB Centres(NDRTBC) at state/regional/district level to manage

seriously ill DRTB cases,DRTB cases with extensive resistance and DRTB cases
to be treated with regimes containing new drugs(Bedaquilline and Delamanid).
●District DRTB Centres(DDRTBC) at district level to manage DRTB cases with MDRTB
and H mono/poly resistance.
C]At the central level,six designated National Reference Laboratories(NRLs) namely

☆National Tuberculosis Institute(NTI),Bangalore

☆National Institute for Research In Tuberculosis(NIRT),Chennai
☆National Institute of Tuberculosis and Respiratory diseases(NITRD),Delhi
☆National Japanese Leprosy Mission for Asia,(JALMA)
☆Institute for Leprosy and other mycobacterial diseases,Agra
☆Regional Medical Research Centre,Bhubaneswar and
☆ Bhopal Memorial Hospital and Research Centre(BMHRC).