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World TB Day Symposium 2015

“Impact of Tuberculosis on Women and Children”

To commemorate World TB Day 2015, National Institute for Research in Tuberculosis (NIRT) conducted a symposium titled “Impact of Tuberculosis on Women and Children” on 23rd March 2015.


The Chief Guest for the Symposium was Mrs. Lalitha Kumaramangalam, Chairperson, National Commission for Women. The Symposium was presided by Dr.C.N.Mahesvaran IAS, Mission Director, National Rural Health Mission, Tamilnadu State.

 

Dr.Soumya Swaminathan, Director, NIRT welcomed the audience and stressed the fact that nearly 130 years after Koch's discovery of Mycobacterium tuberculosis as the causative agent, tuberculosis still persisted as a public health problem. She outlined the challenges faced by women and children due to TB and highlighted the fact that women faced a double burden of physical ill health and stigma, when affected by the disease. She hoped that the National Commission could take up women's health issues, especially with respect to access to health services and more gender friendly clinics.

Dr.Sanjay Mehendale, Director, National Institute of Epidemiology delivered a talk on “Gender issues in TB: A national perspective”. He presented evidence that reflected high rates of TB mortality among females due to delay in diagnosis and treatment. Health screening of women in institutions, and migrants is a neglected area he added. He highlighted the importance of gender equity in health, which needs to take into account gender disparities in education, employment and social status.

 

The symposium also provided a platform for a cured patient with multi-drug resistant (MDR) TB to share her experiences from a patient's perspective. She dwelt on the challenges she faced with regard to the bulk of drugs, the toxic effects of the drugs which was a major reason for her initial non compliance and her own lack of awareness of TB before she developed MDRTB. She lauded the efforts of the NIRT staff in the strong support she received by way of motivation, counselling and urged that more awareness on TB be created among the public. She took great pride in declaring that she is free from TB for the past 5 years.


The highlight of the symposium was a Panel discussion on how to provide better TB health services to women and children. The following members were present in the Panel.

 

•  Dr.Lakshmi Murali, State TB Officer, Tamilnadu

•  Prof. Muralidharan, Dept of Humanities and Social Sciences, IIT Chennai

•  Dr.Jaya Sridhar, THA, Internews Network

•  Dr.Shyamala Nataraj, Founder, South India AIDS Action Program (SIAAP)

•  Mrs.Sudha Ganapathy, HOD (Rtd), Dept. of Social and Behavioural Research, NIRT

•  Dr.Gomathi, Asst.Professor, RSRM Maternity Hospital, Chennai

•  Mrs. Sheelu, Women's Collective

•  Mr.Prasad, Science Correspondent, THE HINDU

The panel discussion was moderated by Dr. Beena Thomas, Scientist, NIRT.


Dr. Lakshmi Murali focussed on the challenges with regard to the stigma faced by female patients especially the adolescents and newly married. The lack of awareness about TB symptoms, mode of spread and treatment adds to the stigma. She felt that the self help groups could play a major role in creating community awareness on TB. Prof. Muralidharan outlined the three dimensions of universal health coverage. He stressed on the need for a TB cost benefit analysis which was lacking. He also pointed out the importance of mobile technology in promoting compliance among TB patients and in creating TB awareness. . Dr.Jaya Sridhar stressed the importance of community involvement in TB control and implementation of interventions through coordinated efforts. She urged the academic fraternity to involve the media more, especially in TB symposiums, dissemination workshops and sharing of information so that they would be able to address these issues. She added that the media was a powerful tool. This was also echoed by Mr.Prasad who said that there was lack of accessibility of information and data on TB for the media. He said this was very crucial and shared the challenges he faced in accessing relevant information on TB. Mrs.Sudha Ganapathy said that studies point to better TB treatment compliance among females. However the challenge was getting females to seek timely care since they were burdened with their roles as care givers giving little care to themselves. She said that it was time that women be care receivers not just care givers.Dr.Shyamala highlighted the need for counselling services in TB as in HIV and presented evidence that pointed to the success of counselling in HIV control . She said that this needs to be replicated in TB as well.


Dr. Gomathi talked about the significance of TB screening in pregnant women. She also added that awareness has to be created among doctors on availability of new diagnostic tests like Gene Xpert. Mrs. Sheelu stressed the importance of nutrition in TB prevention and treatment. She said that the need of the hour was the right nutritional intake, which was still not addressed and emphasised the need for a paradigm shift from the existing food supplies given through the PDS system to the introduction of millets and a more balanced diet. A health drink made from millets was distributed to the participants, which was appreciated. Dr. Lavanya, District TB Officer, Chennai talked about the importance of IEC in TB control and shared some of the activities such as awareness through bus backs, one minute films which the Chennai Corporation was working on. The floor was then opened for discussion and the points raised were with regard to risk factors for TB such as malnutrition, alcoholism, indoor air pollution, lack of proper sanitation, overcrowding , trend of eating food that were cooked on coal such as barbequed foods and the exposure to contacts with TB.


The need for a holistic approach in dealing with TB was emphasised through this vibrant panel discussion

Dr.C.N.Mahesvaran in his Presidential Address talked about illiteracy and environmental conditions contributing to development of TB. He pointed out that holistic approach is needed for TB control. He spoke about creation of awareness among school children, who can be powerful ambassadors.

 

Mrs. Lalitha Kumaramangalam, in her keynote address spoke about the lack of attention to girl children in the community. She mentioned that children should be educated about nutrition and the correlation between nutrition and health. Since nutrition, poverty, alcoholism and TB are interlinked, she stressed about proper coordination between different government sectors. She suggested that involvement of self help groups in TB prevention and control would be a good strategy. She added that educating policy makers and politicians about TB was necessary as the general perception in the community was that TB was not a major public health problem.


Dr.Geetha Ramachandran, Scientist, NIRT delivered the vote of thanks.

 

The scientific session was scheduled for the afternoon. Dr.Smita Mahale, Director, NIRRH, Mumbai delivered a talk on female genital TB and infertility. She talked about the burden of genital TB in India and how it affects women, as the main presenting feature of genital TB is infertility. She also outlined the challenges faced in the diagnosis of genital TB.

 

Dr.Uma Shanthi, Director, Institute of Obstetrics and Gynaecology, Egmore talked about Tuberculosis in pregnancy: current practices and research priorities. She spoke about difficulties in diagnosing TB as the symptoms are masked during pregnancy. She discussed about the importance of counselling pregnant women on treatment adherence, side effects and nutrition.

 

Dr.Soumya Swaminathan, Director, NIRT gave a talk on the challenges in diagnosing and treating childhood TB. She talked about the prevalence of childhood TB, risk factors in children, drug resistant TB, newer diagnostic tools, new drugs under development and latent TB infection.

 

Dr. Padmapriyadarsini, Scientist, NIRT delivered a talk on nutrition and tuberculosis. She spoke about the relation between nutrition and risk of development of TB, key principles of nutritional supplementation and ideal nutritional requirements for TB patients.

 

 

 

" School children-Potential Ambassadors for TB control "


Brief report on TB sensitization programme in schools and painting competition (March 2nd-13th 2015)


There is great need for TB awareness in the community as TB continues to be a public heath problem and awareness is key for timely diagnosis and treatment. It was therefore felt that school children were a great force that could help in promoting TB awareness once they were sensitized. The Department of Social and Behavioural Research, NIRT in collaboration with the Education and Health department of the Corporation of Chennai, conducted TB sensitization programmes in 10 Corporation schools covering 3000 children of 8 th and 9 th grade between March 2 nd -13 th 2015. This programme was done during their morning assembly and included a brief talk followed by a villupattu (Folk art with a song sequence on TB).

After the programme the students of 8th and 9th grade were invited to a painting exhibition competition at NIRT on the 13th of March. This programme was sponsored by BD Diagnostics who distributed the painting material to 120 children from these schools who were nominated by their teachers.

 

The children along with their teachers displayed their paintings at NIRT on March 13th . The students were asked to explain their paintings to a panel of 3 judges selected for this event. Prizes were distributed to the best 6 students and Plaques distributed to the schools which they represented.

 

While the students waited for the results there was an interactive session with the staff from NIRT which helped clarify their doubts and also get a feedback of the TB sensitization programme that they were exposed to in their respective schools.

 

The students expressed a lot of enthusiasm and assured us that they would take these messages to their families and neighbourhood.

 

This event was followed by feedback visits after 2 weeks of the competition. It was encouraging to note the continued enthusiasm of the students as each one shared with the team on how they had reached out to their families, relatives and neighbours. This programme and competition served as a platform to reach the student community who can be powerful ambassadors in TB control.





 

 

" TB awareness through mass media – March 24-26, 2015 "


Creating awareness through mass media can create a great impact as it reaches a large population. With this idea a short film on TB titled “kanne kanmaniyea” was telecast through 3 local cable channels in the Chingleput area between March 24th to 26th 2015 to commemorate World TB day. This area has a population of 7 lakhs most of whom viewed these local cable channels. This film
was done by NIRT in collaboration with TB Association of Tamilnadu and directed by Enkay Vision, Chennai.


 

 

"Nutrition Programme on 20th March 2015 to commemorate World TB Day"


Under nutrition increases the risk of tuberculosis (TB) and can influence treatment outcomes. Nutrition is a major factor which needs to be addressed in TB treatment outcome and effective TB control.



The department of Social and Behavioral organized a nutrition sensitization programme for TB patients and their care givers on March 20th 2015. This programme largely focused on the need and importance of nutrition for health living and effective TB management.

 


We had an interactive session led by a nutrition expert Ms.Sheelu, President Women's collective that has been promoting healthy nutrition and has been instrumental in empowerment of women and their families. She spoke on different affordable nutritious food and stressed on the importance of millets. She cautioned about the use of chemicals in processing the food and also while storing of food given in the public distribution system. She educated the patients and care givers about the harmful effects of using polished food grains and polished sugar. She encouraged the use of jaggery and country sugar instead of polished sugar. She outlined the various millets and their uses. During the programme the patients and care givers were distributed with a drink with which was made out of sprouted millets and jaggery.

 



Feedback from participants

The patients and care givers were very appreciative of the programme, it was very interactive. The participants expressed their interest in including millets in their diet and wanted details on its accessibility and costing. Many of them said that they would follow the recipes that were demonstrated and found the food and drink very tasty. Women care givers expressed the need for more recipes that are of low cost and nutritious.

 

 

The Scientific Committee of Prof. M. Viswanathan Diabetes Research Centre has immense pleasure in honoring Dr. Soumya Swaminathan by awarding her with DRC Gold Medal Oration Award 2015"


 

 

 

Prof Wallace Fox plaque installation & International Symposium on “Recent advances in TB Diagnosis and Treatment”
at NIRT on 15th December 2014"

On December 15, 2014, a plaque to commemorate the contributions of Prof. Wallace Fox, founder Director of the Tuberculosis Chemotherapy Centre ( 1956-1961) was unveiled by Dr. S.P. Tripathy, Former Director General, Indian Council of Medical Research. Mrs. Gaye Fox & five other members of the Fox family attended the function which was also graced by Dr. J. Radhakrishnan I.A.S., Principal Health Secretary, Government of Tamil Nadu, Dr. S. Radhakrishna, former Director, IRMS, Dr. Andrew Nunn, Medical Research Council, Clinical Trials Unit, London, representatives from several ICMR institutes, state government collaborators and retired TRC staff. A symposium on ‘Recent Advances in TB Therapy' was also held. Speakers provided both historical perspectives on TB clinical trials and focused on future needs and priorities

 

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Evaluation of new TB Diagnostics: A capacity building workshop for public sector institutions in India on 8-12th December, 2014"

“Evaluation of new TB Diagnostics” – a capacity building workshop for public sector institutions in India was held at NIRT from 8-12 December 2014 in collaboration with FIND and McGill global health programs and McGill International TB centre.

 

This 5-day intensive workshop was designed for investigators who are primarily involved in TB research. The main focus of this workshop was on the methodology for evaluation of new TB diagnostics including diagnostic algorithms, basic principles, diagnostic study designs, incremental value of new tests, and impact of new tests on clinical decision making and impact on patient-important outcomes.

 

Over 50 participants from Medical colleges, National Reference Laboratories and product developers attended this interactive workshop. The course directors Dr. Soumya Swaminathan, Director NIRT and Dr. Madhukar Pai, Director McGill global health programs welcomed the participants and outlined the purpose and goals of the workshop. The scientific sessions on various aspects of new TB diagnostics and its evaluation were presented by experts in this field. The faculty members were Dr. Catharina Boehme (FIND, Geneva ), Dr. Neeraj Raizada (FIND, India ), Dr. Mayank Ghedia(CTD), Dr. Ranjani Ramachandran(WHO),Dr. Puneet Dewan (Bill & Melinda Gates Foundation), Dr. Samuel Schumacher , Dr. Srinath Satyanarayana, Dr.Hoojoon Sohn (Doctoral Candidates, McGill International TB Centre). There was a brief presentation and technology demonstration of the new TB diagnostic tools by the product developers who attended the workshop. Panel discussions on establishing a process for new tool development, validation and policy in India as well as on reference standards were held on the 2nd and 3rd day. The participants were assigned into small groups to develop protocols on validation of the new technologies that were presented.

 

Five protocols were developed by the groups and discussed in detail on the last day of the workshop. These would be carried forward for doing multicentric studies to evaluate and validate the upcoming new TB diagnostic tests in Indian laboratories.

 

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Dr. Wallace Fox Plaque Installation function & Symposium on “Recent Advances in TB Diagnosis and Treatment” on 15th December 2014"

 

 

 

 

Report on the dissemination meeting on the study titled

“ An experimental study to enhance treatment adherence in tuberculosis patients who consume alcohol ”

A dissemination meeting was held at the National Institute of Research in Tuberculosis (NIRT) – ICMR on the 29th September, 2014 to share the findings of the Alcohol Intervention study undertaken by the Department of Social and Behavioral Science Research (DSBR). The NIRT firmly believes that these meetings will help towards translation to the programme and pave way towards making policy level changes to improve the existing TB control program and strengthen the health systems.

Around 65 members participated in the dissemination workshop which included representatives of the the Chennai Corporation, NGOs, representatives from the RNTCP corporation clinics, DTOs from Chennai and Thiruvallur, Former WHO representative and representatives from NIRT.

Dr. Soumya Swaminathan , Director welcomed the gathering and outlined the importance of such meetings based on evidence based research. She reiterated that it was important to give back to the health community the findings of the study. She especially thanked the support of the corporation in the successful implementation of all studies carried out by the institution. She also outlined the challenges faced in the control of TB disease such as high death and default rate, drug resistant (DR-TB), lack of social support, alcohol use and the problems around TB notification.

   She said our goal was to work towards the goal of a TB Free Chennai. .For this to happen we need public-private organization co-ordination, media, NGOs, involvement of institutes and industries and   community participation.

  

Dr. Beena E. Thomas
presented the study titled “An experimental study to enhance treatment adherence in tuberculosis patients who consume alcohol” . This study was an outcome of two pilot studies on “Prevalence of alcohol use disorders (AUDs) among TB patients” and “Feasibility of alcohol use intervention programmes for patients with AUD” . These published studies reported a high prevalence of AUD among TB patients, the need to address AUDs in TB care and that an alcohol intervention programme was both acceptable and feasible.

This intervention study was done with this background. This was an RCT (Randomised Control Trial) where the experimental group received the intervention. This intervention included 4 individual counseling sessions based on an intervention manual. This was prepared purely through a community participatory approach where the inputs of the TB patients, their families and the health care providers were involved in deciding the topics of the intervention and the type of intervention. Out of 872 TB patients, 31% consumed alcohol. Dual stigma – TB as well alcohol was reported by most patients. The intervention group had a 61% alcohol consumption reduction as compared to the control group. There was also a 51% increase in Treatment completion in the Intervention group as compared to control group. This study emphasized the need to address alcohol dependence in TB control programme. The study calls for trained counselors to be involved in this important intervention to promote TB compliance and reduce alcohol dependence among TB patients.

   Dr. P. Kuganantham, City Health Officer, Corporation of Chennai affirmed that most of the TB patients we cater belong to the lower socio economic group. There was an urgent need to introduce counseling for TB patients with alcohol abuse He said that there wee corporation run de-addiction centers run by the Chennai Corporation which could be used as referral centers for those TB patients who needed alcohol deaddiction treatment .

•  Prof. Dato' Dr. C.P. Ramachandran appreciated the study and said that it was impressive that this study had proved the impact of psychosocial intervention on TB Treatment compliance. Dr. Lavanya, DTO, Chennai stressed on the strong association between alcohol abuse and TB treatment management . She said that Alcohol abuse was a major problem affecting TB treatment complance and welcomed the intervention and said that Helath care providers needed training in implementing this intervention. She said that this was top priority. Dr. Rakhal Gaitonde , Chairperson of the Community Advisory Board( CAB) recommended that the community-based study findings should be translated to the programme and implemented.

The intervention manual which was prepared as an outcome of this study was relaes by Prof CP Ramachandran and presented to all the participants who attended.

 

Release of manual:

  

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Article published in “The New Indian Express” on Monday 6 th October, 2014

"New drug for TB patients could CUT TREATMENT TIME" -The Time of India, November 24, 2014 more...

 

Operational Research Workshop in Tuberculosis at Govt Rajaji Hospital, Madurai on 13th & 14th November 2014, for Medical Officers of Medical Colleges at South Tamilnadu by NIRT

 

A two day workshop on 'Operational Research Workshop in Tuberculosis' at Government Rajaji Hospital , Madurai was organised by NIRT/ICMR in collaboration with Madurai Medical College , RNTCP and The UNION for Medical Officers of Medical Colleges

 

The objective of the workshop was to sensitize the Medical Officers in Operational Research (OR) and capacity building in Medical Colleges and to train the Medical Officers in writing Study protocols on OR in Tuberculosis, and also to aid and guide in conducting the research as per the prepared study protocol and publishing the same.

 

The participants were asked to attend in a team of two(One Faculty + One Post Graduate) and there were a total of 35 participants from the south zone medical colleges including Madurai medical College, and other Goverment Medical Colleges at Trichy, Tanjore,Tirunelveli, Kanyakumari, Thiruvarur and Theni.

 

Dean, Madurai Medical College and Govt Rajaji Hospital , Dr.Santhakumar inaugurated the Workshop. The Speakers and Facilitators included Dr.Sridhar,Professor & Head of TB & Respiratory Diseases,Stanley Medical College and State OR Chairperson, Dr.Lakshmi Murali,Director of STDC & DTO Tiruvallur district, Dr.Ajaykumar,Deputy Director(Research) from The UNION, Dr.C.Palanivel from JIPMER, and the NIRT Scientists including Dr.Mohan Natrajan, Dr.P.Paulkumaran, Dr.P.Padma Priya Dr.S.Ramesh Kumar and Dr.N.Poorana Gangadevi

 

The Workshop had talks on general topics on TB research, challenges in RNTCP, research priorities and funding options in OR on TB, and then specific topics on Operational research.   Practical group sessions were held to develop research questions and protocols. The participants then presented their protocol outline to get inputs and comments from the experts who were in the panel. The participants were informed to communicate with the facilitators for further development of protocol and conducting the research. About 19 study proposals were developed in the workshop, with topics including TB & diabetic management strategies, strategies to improve TB treatment outcomes, Gene expert in extra pulmonary TB in adult and paediatric population etc.

 

The outcome expected from this workshop is generation of operational research studies on tuberculosis, which would further help in improving the TB program in India(RNTCP).

 

The Workshop was partly funded by ICMR and partly by RNTCP

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Fighting Indias silent epidemic - The Hindu Dt: October 13, 2014

 

 

 


 

 

 

Prof. Jacob Abraham has been awarded the Annual Research Day distinguished retired faculty medal and oration for the year 2014. more...

 

Dr. R Rathinasabapati, Senior Library & Information Officer has featured in “Emerald Who's Who in Asia” – published by Rifacimento International in its © 2014 edition.

 

 

Research Dissemination workshop on “Operational research findings from the Model DOTS project (1999-2014)” 2nd and 3rd September 2014, NIRT, Chennai.

In 1999, the World Health Organization ( India ), the Central TB Division, the Government of Tamil Nadu, the Tuberculosis Research Centre (TRC) set up the “ MODEL DOTS ” Project (MDP) with financial support from the USAID through WHO . The objective of this project was to demonstrate the impact of DOTS in a high burden community setting. The district selected for this project was Tiruvallur 50 km from Chennai which facilitated close monitoring of the various research studies that were initiated.

A 2 day research dissemination workshop was conducted at NIRT, Chennai on 2 nd and 3 rd September 2014 in order to communicate and disseminate the operational research findings from MODEL DOTS project to the scientific community, TB program managers and Medical college faculty. The meeting was a two-day programme with a series of sessions that included presentations from NIRT as well as other institutes and Zonal task forces working on the operational research aspects for TB control in India. Over 70 scientists, program managers, consultants, NGOs, Chairs of the Zonal Task Force from Medical Colleges all over India , attended this workshop.

Dr Soumya Swaminathan , Director NIRT welcomed the gathering and outlined the objectives and need for of the workshop and the outcome of the deliberations. Dr.D.Behera, Chair, National Research committee on Tuberculosis presented the challenges of conducting operational research, the need for participation from medical colleges and the barriers that need to be overcome to facilitate this participation. This was followed by Dr.Reuben Swamickan, Project Management Specialist (TB), USAID India, who elaborated on the USAID priorities and the need for engagement with the private providers and NGOs, Dr.A.Sreenivas National Professional Officer, WHO India stressed on the need to move above exploring the risk factors and problems associated with TB and to focus on the interventions that provide solutions to these problems.

On the occasion of this workshop NIRT released a monograph, titled “MODEL DOTS Project (1999-2014)-Genesis and Achievements”. This monograph was a compilation of the various operational research studies undertaken by NIRT in the last 15 years and its implications in shaping RNTCP policies. Dr.D.Behera released the monograph and the first copy was received by Dr.P.R.Narayanan, former Director NIRT. Dr. Mohan Natrajan , HOD, Department of Clinical Research, proposed the vote of thanks.

Following the inaugural were the scientific sessions where presentations were made on the operations studies done by NIRT under the MDP project presented by scientists who were involved in the various studies as well as those currently involved in the MDP studies. . Presentations covered clinical, operational, sociobehavioral, economic impact, bacteriological studies, and molecular epidemiology and pharmokinetic studies. The second day focussed on presentations on operational studies from other ICMR institutes and Regional Task force Chairs, NTI (National Tuberculosis Institute), Central TB division) ,Union and NACO followed by a panel discussion.

The panel discussion was on the topic “Operational research needed for achieving new RNTCP program targets”. This panel summarised the discussions held at the workshop and recommended the need for strengthening TB surveillance system to understand the burden and epidemiology, engaging private practitioners and NGOs, applying molecular epidemiology tools, testing new drugs and regimens, testing new models of intervention for TB control and translation of research findings into policy in a timely manner,

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The ICMR Tribal Forum Annual Meeting 2014 Report

Ever since the Tribal Health Research Forum (THRF) was established on 9 th August in the year 2010, the mission of the forum was to commit in improving the health status of the tribal population and provide them with a quality of life. This has driven the design and development of the THRF Annual Meeting programme. The THRF meetings remains the foremost creative force for engaging leaders from various institutes in collaborative activities focused on bringing the interests of the tribal people to a stand.

 

The ICMR 11 th Annual Tribal Forum meeting was held at the National Institute for Research in Tuberculosis (ICMR), Chennai on the 09 th of August, 2014. The programme was conducted alongside the commemoration of the “International Day of the World's Indigenous People” with the theme “Bridging the gap: Implementing the rights of Indigenous people.”

 

Around 60 members from 23 institutes across the country participated in the 11 th Tribal Forum Annual Meeting with cautious optimism. It was a two day meeting with a series of sessions including presentations, discussions and a visit to tribal areas. The main objective of this meeting was to bring all the ICMR as well the non-ICMR institutes together to address and discuss on the issues and challenges facing the tribal population with a motive to ‘ reach the unreached '.

 

The meeting was a two-day programme with a series of sessions that included presentations from ICMR as well as non ICMR institutes working for Tribal Welfare the first day and a field visit the second day. The inaugural session included a welcome address by Dr Soumya Swaminathan . articulated mainly on the health disparities and indicators faced among the tribes in India . She spoke on some of the common health-related issues prevailing among the Tribals. She said that problems like diabetes, under-nutrition, sickle cell anaemia and starvation are some of the most existing health issues in the Indian tribal settings. Adding to this, she also said there is an increase in non-communicable diseases and other infectious disease in this population. Against this background she highlighted the need to address the challenges faced by the tribal population.

 

This was followed by the opening address by Dr Neeru Singh, Director RMRCT, who has been the coordinator of the Tribal Forum ever since its inception in 2010 and has successfully coordinated 11 meetings which include 4 annual meetings. She recalled the growth of the THRF and its achievements in establishing Tribal Health Units at different institutes. A special issue of the Tribal Health Bulletin 2014 and the Electronic Database of Tribals was also displayed. The proceedings of the meeting were chaired by Gen Raghunath who also gave a special address. The oration of the day was titled' Tribal Welfare-Challenges & the way forward' was given by Dr. Nandakumar Menon, Director of Gudalur Adivasi Hospital, Tamil Nadu. He shared the issues and challenges faced by the Adivasis and the innovative strategies adopted to reach them and win their faith in them which helped them fulfil completion of their responsibilities which focussed on their welfare thus enabling them to achieve a life of dignity. The highlight of the sessions was a presentation by Mr Sreedharan a tribal leader who belongs to the Mullakurumba tribe. He leads one of the 8 centres run by ASHWINI (Association for Health Welfare in the Niligris) a registered charitable society founded by Dr Nandakumar Menon. He delivered an overview of the difficulties and problems faced by the tribal community and the initial fears they had before the project has taken the shape it has in its present status. He said that they had immensely benefitted by the efforts of ASHWINI and the Gudalur Hospital was a great achievement which was open to Adivasis and Non adivasis.

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Smt. Kannagi Packinathan IAS, Adi Dravidar & Tribal Welfare Secretary, TN enlightened the gathering by highlighting the efforts of the government in empowering the tribal communities. Considering this, she said that, “Inadequate funding is not the problem, infact it is the shortage of social policy makers and inefficient planning and execution of the policies that remains a stumbling block on the path of tribal development and progress.”

 

Shri T.S.Jawahar, IAS, Sr. DDG (A), ICMR: appreciated the efforts taken among the tribal communities by quoting the concept of geometric progression. He shared his experience about the days when he served as a Nagapatinum District Collector during the post tsunami period where intense rehabilitation work was carried out. He listed 10 goals which one needed to keep in mind for success of any project. Mr. Sanjiv Datta, Advisor to DG said that successful research under ICMR resulted in the formation of the tribal health forum. He stated that the thinking process of the people has changed and that the success of the scheme depends on how the ICMR translates its findings for the health of the tribal population.

 

Dr. V.M.Katoch Director General, ICMR & Secretary, Dept of Health gave the presidential address. He said that when we celebrate the ‘World's Indigenous Peoples Day', each one should think about bringing transformation for the well-being of the Tribals. He called for implementing action and promoting development for the interests of the tribes rather than making contributions that are in fragments. He appreciated that ICMR had done remarkably in the field of health research and how the tribal forum had grown. He called for integration and collaboration of various organizations ICMR and non ICMR. He reminded the gathering that science was a vehicle for change and the need to commit ourselves to the cause of tribal welfare by making a difference.

 

The afternoon session was a panel discussion which included Dr Amit Mitra, Anthropologist, Dr Chandrika, MSSRF, Dr Sudhakar and Dr KR John. They were able to share the work that they had done which had made a difference in the tribal communities they worked in and highlighted the challenges they faced in making a difference. Dr Sudhakar who was instrumental in introducing the 108 ambulance facility talked about the need to concentrate on simplistic messages and simple strategies to bring about big results. He stressed on the need to believe that change is possible despite the challenges that one faces.

 

This was followed by presentations by Directors and scientists of the various ICMR institutes on the research studies in Tribal health undertaken and the findings from the study relating them to the action taken thus far.

 

The next day was an exposure visit to the ‘Irular' tribal community in Kancheepuram district, Tamil Nadu, on the 10 th August, 2014. This included visits to the Irula Society to witness their involvement in venom extraction, an irular village where the villagers were met with and there was a lot of interaction. It was of great significance when Shri Jawahar, DDG was recognised and greatly appreciated by the Irula community for his contribution for their welfare in getting them community certificates that had helped them progress and have opportunities in society. This visit was followed by a visit to the Society in Thandarai to see the herbal garden and manufacture of indigenous medicines by the Irula tribal women and be a part of a temple festival that was going on in the community.

 

This report is intended to serve as a memento and as a catalyst that stimulates further thinking on the issues and questions that were raised on tribal health at the meeting.

 

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Report on the programmes conducted for World TB Day

 

Every year March 24 is observed as TB Day worldwide. While great efforts have been made to control and cure TB, people continues to be a major public health problem. This day reminds all of us on the need to continue all efforts to combat the disease through TB advocacy at all levels considering that lack of TB awareness continues to be major impediment in TB control. The National Institute for Research on Tuberculosis conducted numerous community awareness programmes to mark this event. This was done in collaboration with the State, district, NGOs and Health care providers from the TB corporation clinics.

 

 

Description on the TB awareness programmes:

 

The first programme was on March 1st for superintendents of the various prisons in Tamilnadu , medical officers of the prisons and counsellors . This was conducted as it was felt by the IG of prisons that TB transmission in prisons was a matter of concern and needed attention. The group was addressed to by the Director of NIRT, DTO-Dr Lakshmi Murali, Dr Vanaja and Dr Valan form TANSACS, Representatives from the Akshay project, WHO consultants, Dr Pradeep and Dr Beena from NIRT. Various topics were covered which included facts about TB, MDR TB, need for early diagnosis, importance of follow up and adherence for treatment as well as mental health issues pertaining to stigma and depression in prisons.

 

 

 This was followed by a number of community awareness programmes in the general community both in rural and urban areas, among school children and in heath centres for TB patients and their families. All the community programmes were more interactive and tailored to meet the needs and level of understanding in the community. These programmes included a brief talk on TB , role plays, villupattu on TB and screening of a movie on TB. These programmes ended a feedback session during which the participants were motivated to raise questions and clarify their doubts regarding TB. The participants were also provided with IEC materials in the form of pamphlets and posters. The social workers and counsellors of the NIRT were also exposed to a session on Cognitive Behaviour Therapy to equip them with skills to deal with TB patients and families.

  

  • 9th March at Annai Sathya Nagar an urban slum for nearly 45 community members of all age group. The student trainees from Loyola College joined the NIRT team in the TB awareness campaign and enacted a role play on TB. The same day a TB awareness programme was conducted among the patients attending the corporation centre at East Cemetery Road.

  • March 10th –A session on Cognitive Behavior Therapy was held for the social workers and filed investigators of the NIRT. This programme helped to understand the importance of cognitive behaviour therapy especially in dealing with TB patients considering the manifold mental health issues that a disease like TB entails. This intervention helps to work on the cognition of patients and address the felt needs of TB patients cope with their illness thereby facilitating adherence for TB treatment. This session was addressed by Mr Thaddeus Alphonse an expert in CBT

  • On 17th March a TB awareness programme was held among the school children of a Government High School for children in classes 6 to 10 and nearly 200 students were addressed. The students were very enthusiastic and enjoyed the villupattu and role play. The feedback was encouraging.

  • On 15th March a programme was organised in Sathya Vani Muthu Nagar , Ayanavaram for the self help group women(SHG) of the area. The programme was conducted in an ICDS centre. Nearly 50 SHG women participated in the programme. The women were very participatory and the session was productive.

  • On 18th of March a community awareness programme was held for the basin bridge neighbourhood where around 70 members of the community were addressed on TB.

  • On 19th of March a TB programme was organised in the rural area in Neyvelli panchayat of Thiruvallur district . This was organised in collaboration with the the local panchayat leader who was very keen that a TB awareness programme be organised in his panchayat. This was held in the government school and the audience included all the school children, teachers, women from the NREG(National Rural Employment Guarantee Scheme). We had the district TB officer Dr. Lakshmi Murali join the NIRT team for this function which included interactive talk, a villupattu and a movie on TB.

 

21st March - Painting and Quiz Competition for school children

 The painting and quiz competition was organized as an innovative strategy to generate knowledge on TB among school students for TB control. The schools were approached 10 days earlier to the competitions and children were urged to do their research on TB and reflect it in paintings and or volunteer to be part of the quiz competition which were to be presented at the competition. Around 100 students participated in the painting competition. The paintings were displayed and judged, and the prizes were given to the winners of the competition. The quiz competition was carried out professionally with 6 schools represented – 3 from each school (7th to 9 th grade).45 students from various schools volunteered for the Quiz programme of which 15 students were selected for the competition through a screening test. These students were divided into 5 teams, each team consisting of three members. The quiz was grouped into three rounds with each round carrying five questions, for each team, based on general health, health organizations and human physiology, and on tuberculosis. Prizes were given to the respective teams bagging the Ist, IInd and IIIrd place.

 

After the paintings were displayed and the quiz completed the students, teachers and parents who accompanied them were addressed on TB and their doubts and misconceptions clarified. This competition provided a platform for students and teachers to understand TB, clarify their doubts and understand the role they could play in creating TB awareness in the communities they live in. This was indeed a very successful event and the ideas and creativity that students displayed was truly admirable and deeply appreciated.

 

 

 

 

 

 

 

 

 

 

 

 

 

Social and Behavioral Research Studies on TB- Challenges and the Way Forward Dissemination Synopsis: 4 th April 2014

 

Objectives:

•  To disseminate TB research findings among various stakeholders including policy makers, health officials, academics, NGO representatives, and health practitioners

•  To bring these various stakeholders together to facilitate their discussion on the implications of NIRT's research's for TB control

•  To precipitate efforts to create policies or programs to address TB, based on the research conducted by the Social and Behavioral Research Department at NIRT

 

 

 

Attendees:

 


Those in attendance include Mrs. Mythili Rajendran (Managing Director and CEO, Tamil Nadu Corporation for Development of Women), Dr. K.S Sachdeva (Additional Deputy Director General, Central TB Division) Dr. P Kuganantham (City Health Officer, Corporation of Chennai), ), Dr Kolaindaswamy Director of Public health, Dr. Arivoli (State TB Officer), Dr Ayyanar, Director of Immunization , Dr. Lavanya and Dr. Lakshmi Murali (District TB Officers), Dr. Azad Kundu (ICMR), and Dr. Rama Baru (Professor, Centre of Social Medicine and Community Health, Jawaharlal University), Dr. V. S Raja, Dr. Shezia, and Dr. Delphina (WHO consultants)RNTCP Medical Officers, treatment supervisors, Heath visitors, counselors, NGO representatives (REACH), academicians, Community Advisory Board members, representatives of the ethics committee, NIRT staff, and members of other ICMR Institutes (NARI).

 

NIRT Socio behavioral Studies:  

 

 

•  A community based approach in designing a model TB sensitization programme for Self Help Groups (SHG's)- A study from Tamil Nadu, Thiruvallur

•  Health seeking behavior pattern of migrant brick kiln workers- A study from South India

•  Prevalence of Alcohol Use Disorders among TB Patients- Feasible interventions to enhance treatment adherence in tuberculosis patients who consume alcohol

•  Psychosocial issues in MDR TB

 

A TB sensitization manual which could serve as a guide for self help groups was released. This manual was prepared based on a community based approach and an outcome of the study.

 

 

Recommendations:

 

Recommendations from the NIRT studies include:

•  The need for TB counselors at TB centres

•  The involvement of SHGs in TB control (in spreading TB awareness in local communities, referring TB symptomatics, and as DOTS providers).

•  The need for active case finding and more TB sensitization among migrants such as brick kiln workers to enable early diagnosis and treatment.

 

 

Responses:

 

Mrs. Mythilli Rajendran, Managing Director and CEO, Tamil Nadu Corporation for Development of Women, stated that her organization could collaborate with ICMR to train local community members to become lab technicians and other paraprofessionals needed for TB control. She said that there were 85 lakh self help groups and they have proved to be very effective in health prograames especially in MCH activities and also in tackling social issues. She opined that they could be a powerful force in TB control, activities. She was appreciative of the manual that was released and said that she could also offer to make it more community oriented as they had a group that was involved in this task.

 

Dr. Sachdeva, Additional Deputy Director General, Central TB Division, stated that, based on findings of the alcohol prevalence study, there seems to be a sizeable number of alcohol dependent TB patients. He was supportive of the need of alcohol screening and alcohol interventions for TB patients with alcohol use disorders. He also supported the need for counselors but considering the financial implication he

said that this would be spaced out and the focus would be initially on counselors for MDR TB . He was appreciative of the enormity of self help groups and the potential of them being involved in the TB control prograames. He welcomed the concept of para professionals suggested by Ms Mythili Rajendran .

 

Dr. P Kuganantham, City Health Officer, Corporation of Chennai, responded that counseling needs to be integrated into the healthcare delivery system. He also stated, “SHGs are the pillar of their communities. There is no stigma among these groups and they have helped HIV positive women. Let it not be a missed opportunity to use these women for other health initiatives.” Additionally, he noted that the migrant population in Chennai is large, though neglected. There is little penetration of healthcare for these people, despite great need.

 

There was an open house discussion which provided a platform for the participants to voice their experiences, learn from their experiences and take into considerations some of their suggestions which included

 

  • Explore other task forces such as Trade Unions, corporate community to be included in TB control activities
    .
  • The need to learn from the success of the HIV control programme in terms of the community demand and the importance of counselors in all ICTcs
  • The need to also focus on the males as SHGs are a female dominated force

 

This dissemination workshop was productive and helped take the study findings forward with the recommendations made from the studies and the responses from the policy makers.

 

 

Launch of Project “Accelerating access to quality TB diagnosis for pediatric cases in Chennai, Hyderabad, Kolkata and New Delhi”

Invitation

Xpert Pediatric Request form-FIND-RNTCP-Ped TB

Paediatric FAQs

 

 

 

Workshop on “Clinical Research Methodology and Biostatistics”
March 13 – 15,
2014 at NIRT, Chennai

The NIRT organized a 2.5 days interactive workshop on “Clinical Research Methodology and Biostatistics” for medical postgraduates from Government and private Medical colleges in Tamilnadu, with an ultimate aim to promote medical research in India . The workshop was attended by 45 participants, MD students from various faculties like General Medicine, Chest medicine, Pediatrics, Preventive and Social medicine from Govt. Stanley Medical college, Madras Medical college, Madurai Medical College , Tiruchy Medical college and Salem Medical College . There were also participants from private medical colleges of Coimbatore and Pondicherry . The workshop was also attended by DNB candidates from private teaching institutions like Apollo hospitals Ltd, Child trust hospital and Kamakshi memorial hospital etc.

 

The workshop faculty consisted of experienced and senior research scientists of NIRT who covered various topics like Study design, Operational research, randomized clinical trial, Qualitative research, Proposal writing, Budget etc. Medical Biostatistics – basics and advanced; Ethics in clinical research, including the current DCGI scenario in India were dealt by expert speakers during the workshop. The participants were taught on writing a conference abstract, preparing a power point presentation; manuscript writing and literature search during this 2.5 days training. There was also a demonstration of “End note” software, which helps to manage references during manuscript or thesis writing. The workshop also consisted of breakout sessions in the evenings, when the participants were divided into 6 groups of 7 members each. The participants were grouped based on the area of their expertise and interest, and were asked to build a one-page proposal (concept note) with the help of NIRT mentors, on few pre-identified research priorities (Meet the faculty). On the last day, each group presented their research idea/proposal in the prescribed format to the judges/ mentors and rest of the group. This session was very interactive and well received by all participants and the mentors. Participation certificates were given and the group was encouraged to develop their concept notes into full-fledged projects with the help of NIRT staff and mentors. The Research methodology workshop was well received and appreciated by all participants with a request for continued support from NIRT in building research capacity in medical colleges in the country.

 

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Zonal Workshop on JGate/JCCC@ICMR” on 10 th March 2014 at NIRT for Southern Regional ICMR Institutes

 

 

Workshop on " Clinical Research Methodology & Bio-statistics" on March 13-15th 2014

 

 

Nursing Workshop on November 30th 2013

Photo Gallery

 

Awards/Honours

Dr. P. Venkatesan, Scientist E, is being honoured with “Lifetime Achievement Award” by “The Tamilnadu Dr.MGR Medical University”, Chennai, in due recognition of his contribution to Medical Sciences.

The First Statistician to get this award from “The Tamilnadu Dr.MGR Medical University, Chennai and the second for TRC/NIRT , ICMR

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Dr.P. Selvaraj, Scientist ‘F', for being awarded with “ICMR Chaturvedi Ghansyham Das Jaigopal Memorial Award” for the year 2009. The award distribution ceremony was held on 24 th September, 2013 at New Delhi.

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Ms. Jayalakshmi Vadivel, DNS, is being honoured with “National Florence Nightingale” award for Nursing 2013, given in public recognition of valuable services to the community as Nurse by Ministry of Health & Family Welfare, Government of India, New Delhi on 12th May 2013.

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ICMR-FERCAP Standard Operating Procedures training course for Ethics Committee Members

 

 


Training workshop on

"Improving the Quality of Care for Children with TB and Drug- Resistant TB"

The Training Workshop on "Improving the Quality of Care for Children with TB and Drug- Resistant TB" was jointly organised by the National Institute for Research in Tuberculosis (NIRT) and the Sentinel Project on Pediatric Drug–Resistant Tuberculosis, with financial support from the Global TB Programme , WHO Geneva. The workshop was held in the conference Hall at NIRT, Chennai on June 17-19, 2013.

The Sentinel Project on Pediatric Drug-Resistant Tuberculosis is a global partnership of researchers, caregivers, and advocates who share a vision of a world where no child dies from this curable disease. This workshop was the first step of the Sentinel Project learning collaborative to start of a mentorship process for ongoing activities to improve the quality of services provided to children in the country.

The workshop was attended by Pediatricians and RNTCP staff from all over the country who are involved in the Management of Pediatric TB and DR-TB in the RNTCP programme. The faculty members included Senior specialists, pediatricians , microbiologists and Programme managers from various institutions with expertise in the field of pediatric TB/DRTB.

The objective of this workshop was to provide locally relevant baseline training for state teams on pediatric TB/DRTB and to form a group of national experts on the management of pediatric DR-TB, who will serve as trainers and mentors in their respective states. It also aimed to identify barriers and facilitators in including children in PMDT in India and to provide a feedback to Central TB division on the actions required to improve access.

 

The workshop was inaugurated by the honorable Principal Secretary for Health Dr. J .Radha Krishnan, presided by Dr. R.S. Gupta , Deputy Director General, Central TB Division, Min. of Health & FW, Govt. of India, Dr. Laxmi Murali, State TB Officer of Tamil Nadu and Dr. Meenakshi Director, Institute of Thoracic Medicine, Chennai . Dr. Soumya Swaminathan , Director, National Institute for Research in Tuberculosis welcomed the participants and briefed about the need and importance of the workshop. Dr. Gupta in his presidential address stressed the great need for a group of well trained doctors in the country, who can guide and mentor others in the management of DR-TB in children

 

The workshop was organised into 6 sessions, on namely: Epidemiology; Diagnosis; Management of Paediatric DR-TB ; Adherence, monitoring and evaluation; Prevention strategies and infection control; and Future directions. Presentations in the respective sessions were followed by either brain storming sessions and discussions in the wider plenary group or in smaller break away groups. There was a practical demonstration on gastric aspiration by Dr Carlos Perez. Innovative methods like immobilization, string test and the various aspects of ideal ways of collecting specimens in children for a better diagnostic yield was discussed

 

The meeting also agreed that there is an urgent need for relevant operational research in many areas of Paediatric TB as it was recognized that the existing evidence base is limited. A number of topics were flagged by participants during the workshop. These will be worked on further by the respective participants, with the support of the national and international facilitators. Next steps and recommendations to CTD were finalized in the concluding session

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World TB Day Symposium on Drug Resistant Tuberculosis

   

National Institute for Research in Tuberculosis, Institute of Thoracic Medicine & Madras Medical College conducted a world TB day symposium on “DRUG -RESISTANT TUBERCULOSIS: CHALLENGES & WAY FORWARD” on March 16, 2013 (Saturday) at Government Rajiv Gandhi Medical College Seminar Hall, Chennai.

The symposium was inaugurated by the honorable Health secretary Dr .J .Radha Krishnan, presided by Dr. Kanagasabai Dean, Madras Medical college. Dr. Soumya Swaminathan , Director, National Institute for Research in Tuberculosis welcomed the gathering and briefed about the need and importance of the symposium as it is the need of the hour. Dr. Kanagasabai in his presidential address stressed the importance of the treatment adherence and follow up of the patients especially for toxicity management and also said that the health care providers should be patient friendly. The health secretary in his key note address said that the Medical community should have a long term vision on TB treatment and prevention , aim not only to achieve the goal of zero TB deaths should but also aim to eradicate TB like small pox. He praised that the organizers have taken efforts to unite all stakeholders who work for Tb from Government medical college & hospital, private medical colleges, NGOs and State TB cell to gather for this symposium. He said that the scientific sessions are perfect blend of all aspects of DR TB. The symposium was attended by Professors and doctors of thoracic medicine from Insitute of thoracic medicine , Stanley Medical College ,GHTM , Tambaram, Kilpauk Medical College, Otteri TB Hospital, SRM medical college, Reach NGO , Madurai medical college. The following Topics on Epidemiology & Management of Drug resistant TB & Practical issues in managing Drug Resistant TB were presented and discussed in detail by eminent speakers Dr. Meenakshi , Director, ITM, Prof & HOD Thoracic Medicine, MMC gave away the vote of thanks.

 

World TB Day Symposium Photo Gallery

 

 

 


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