NTBLCP · National Strategic Plan 2021–2026

DR-TB Programme Overview

Case notification rate

124/100k

all TB forms · vs 60 in 2019

target 153/100k · by 2026

TB treatment success

89%

patient-centred services

target 90% · by 2026

Childhood TB share

13%

of all TB cases

target 16% · by 2026

MDR/RR-TB notified vs estimated

54%

vs 11% baseline in 2019

target 70% · by 2026

Resistance-pattern classification

module 4

How many of the active DR-TB cohort each resistance pattern represents. Source: GeneXpert MTB/RIF, LPA, pDST.

Rifampicin-resistant only (RR-TB)38%956
Multi-drug resistant (MDR-TB)49%1,234
Pre-XDR-TB9%226
Extensively drug-resistant (XDR-TB)4%101

Programmatic classification

history-based

Classification by treatment history at enrolment. Drives the recommended regimen and the cohort the patient is counted in.

New41%1,032
Relapse24%604
Treatment after failure14%352
Treatment after lost-to-follow-up12%302
Transferred in / other9%227

Bacteriologic conversion · monthly cadence

smear & culture · WHO cadence

Share of the active cohort that has achieved a negative result at each monitoring window. Drop between adjacent months flags either retention or biologic failure.

Baseline

2,517 pts

64%

Month 2

2,461 pts

78%

Month 4

2,398 pts

84%

Month 6

2,326 pts

88%

Month 9

2,241 pts

91%

Month 12

2,104 pts

93%

End-of-treatment

1,842 pts

aDSM · Active Drug Safety Monitoring

last 30 days

Adverse-event reports by organ system. Serious AEs trigger pharmacovigilance reporting within 24 hours per NTBLCP protocol.

Hepatic

mostly grade 1–2

LFT + dose review

Renal

monitor creatinine

Adjust capreomycin

Ototoxicity

audiometry needed

Stop injectables

Cardiac (QTc)

Bdq/Dlm/FQ exposure

ECG every 2 wks

Psychiatric

cycloserine / Pa

Counsellor referral

Hematologic

linezolid > 4 wks

FBC + bilirubin

Gastrointestinal

usually grade 1

Symptomatic mgmt

Dermatologic

rash · isoniazid

Switch H · cFLD

DR-TB / HIV co-infection

module 7

Co-infected cohort. Targets aligned with the 95-95-95 framework adapted for DR-TB / HIV (test → start ART → suppress).

Tested for HIV at baseline

100%

614 of 614

HIV-positive on co-trimoxazole (CPT)

96%

198 of 614

On Anti-Retroviral Therapy (ART)

92%

190 of 614

Viral load < 1000 copies/mL

84%

173 of 614

Special situations

module 8

Cohort sub-groups that require tailored regimens, monitoring, or counselling per the NTBLCP DRTB modules.

Pregnant / lactating

No injectables, no Pa, no aminoglycosides

Bdq-Lzd-Lfx individualised regimens.

Children < 15 years

197

Paediatric formulations issued

Weight-band dosing, parental counselling.

Adults > 65 years

124

Renal / hepatic dose-review

Home-visit DOT preferred.

Diabetes mellitus

281

Glycaemic control + DR-TB

HbA1c quarterly.

Incarcerated patients

Coordinated handover at release

Linkage to LGTBLS post-release.

Pre-existing liver disease

Avoid hepatotoxic FLDs

Bdq-Lzd-Cs-Lfx anchored regimens.

Treatment outcomes · cohort to date

module 9

Cohort outcome breakdown using the WHO definitions adopted by NTBLCP. Pre-treatment LTFU and Post-treatment LTFU are tracked separately.

Cured

62.4%

1,571 patients

Completed

24.8%

624 patients

Pre-treatment LTFU

3.6%

91 patients

Post-treatment LTFU

5.8%

146 patients

Failed

1.9%

48 patients

Died

1.5%

37 patients

Infection Prevention & Control · facility readiness

module 11

% of DR-TB-treating facilities meeting each NTBLCP IPC requirement this quarter.

Cough triage & fast-track

88%248 / 281 facilities

Isolation room available

71%199 / 281 facilities

N95 / FFP2 respirators in stock

82%230 / 281 facilities

Adequate natural ventilation

91%256 / 281 facilities

UVGI fixtures functional

53%149 / 281 facilities

IPC officer designated

96%270 / 281 facilities