Notification of tuberculosis cases in India: Moving ahead in Revised National Tuberculosis Control Program

Feasibility of a mobile based Continuing Medical Education (CME) program for recent updates in the medical colleges of Himachal Pradesh, India

BACKGROUND

Mobile based messaging system provides a platform to communicate to health care professionals of medical colleges for an updated knowledge in Revised National Tuberculosis Control Program (RNTCP) in the state of Himachal Pradesh.

MATERIAL AND METHODS

Pragmatic trial under routine programmatic conditions was planned in which an automated messaging system was developed along with development of message banks tailored for medical faculty (total 335) with respect to their discipline.

RESULTS

Message banks were developed by the research team by referencing the relevant training modules and guidelines under RNTCP. Two message banks consisted of relevant message lines were developed; one was for case notification, revised presumptive definition, and revised diagnostic methods and general information and another one was for INDEX-TB guidelines. Different combinations -input system - of message lines were decided and designed for both message banks. Input system was kept for one-month cycle with delivery of messages on fixed day and at fixed time (usually at 19:00h on a selected day) to ensure sustained interest and effective reading time for messages.

CONCLUSION

Mobile based medical education program to the medical faculties proved to be feasible and useful to keep them updated about recent changes in the RNTCP.

Future directions for notifiable diseases: tuberculosis-related laws in the Philippines

BACKGROUND

With the increasing burden of tuberculosis (TB) in the Philippines, and the risk of multidrug resistance to TB, there is a need to strengthen the surveillance system. In many countries, cases of TB are reported to health authorities, and reporting is an effective way to manage TB. Although TB is a universal and representative reportable disease, the Philippines does not designate it as a notifiable disease.

MAIN TEXT

This study aimed to review and compare current communicable disease-related laws and regulations in the Philippines with relevant international laws and regulations in other countries, to highlight where current TB notification regulations require change, or to determine whether they reflect global trends. Furthermore, we aimed to have TB included along with other communicable diseases on the list of legally required notifiable diseases in the Philippines. We reviewed current TB-related laws, acts of parliament, executive orders, presidential decrees, administrative orders, and memorandums. We undertook a literature review of relevant World Health Organization documentation, with 17 countries selected for comparison. Data on reported TB cases in the Philippines were obtained from health authorities, and health legislation data from foreign countries was collected from a public law database or from the government websites of each country. Most of the selected countries have a legislative basis for regulating notifiable diseases. In many countries, including Australia, Canada, China, Kiribati, Nauru, Niue, New Zealand, the Republic of Korea, Singapore, the United Kingdom, and Vanuatu, laws on communicable disease notification include TB notification. Our results suggest that notification of communicable diseases should be enforced through domestic health legislation.

CONCLUSION

To align the Philippines with standard practice in the selected countries, TB could be included on the list of notifiable diseases in one of two ways. First, the current regulation "Revised List of Notifiable Diseases, Syndromes, Health-related Events and Conditions of 2008" could be revised to include TB. Second, new TB regulations could be introduced and implemented. Any revisions or new regulations should specify methods to identify and manage TB, and safeguard individual rights.

Mandatory tuberculosis case notification in high tuberculosis-incidence countries: policy and practice

Mandatory tuberculosis (TB) notification is an important policy under the End TB Strategy, but little is known about its enforcement especially in high TB incidence countries. We undertook a literature search for selected high-incidence countries, followed by a questionnaire-based survey among key informants in countries with high-, intermediate- and low-TB incidence. Published literature on TB notification in high-incidence countries was limited, but it did illustrate some of the current barriers to notification and the importance of electronic systems to facilitate reporting by private providers. Required survey data were successfully gathered from 40 out of 54 countries contacted. TB is notifiable in 11 out of 15 high-incidence countries, all 16 intermediate-incidence countries, and all nine low-incidence countries contacted. TB case notification by public sector facilities is generally systematised, but few high-incidence countries had systems and tools to facilitate notification from private care providers. In the context of the new End TB Strategy aimed at eventual TB elimination, all countries should have TB on their national list of notifiable diseases. Enhancing the ease of notification by private providers is essential for effective implementation. To that effect, investing in strengthening disease surveillance systems and introducing digital tools to simplify notification are logical ways forward.