Preparation of Patient-wise Boxes [PWB] for DR-TB Patients

Under the National TB Elimination Program (NTEP), Drug-resistant TB (DR-TB) patients receive standardized DR-TB treatment boxes (called Patient-wise Boxes - PWB) for each month. These boxes are either with the health facility nearest to DR-TB patients (DOT centre) or with the treatment supporter who is involved in the care of DR-TB patients. 

Steps involved in the preparation of second-line drug boxes for DR-TB patients:

1. NTEP State Drug Store (SDS) receives quality-assured second-line drugs from the centre through the General Medical Stores Depot (GMSD) and/or Central Medical Services Society (CMSS).
2. The loose medicines are utilized for individual patient-wise box creation at the SDS/DDS by the store staff.
3. Each patient-wise second-line drug box is prepared according to the NTEP standard box preparation guidelines utilizing the logistics, labels and drugs, and the same details are entered in Ni-kshay Aushadi for maintaining accountability of all drug boxes.
4. Each patient-wise box needs to clearly mention the batch number of different drugs it contains, the expiry of the drug box and individual drugs, and any specific instructions that need to be followed, e.g., temperature, humidity or local storage.
5. Second-line drug regimen box for INH mono/ poly regimen can be prepared at the district level considering its 6-month duration with the selected 4 drugs while Bdq/ Dlm regimen-based boxes are usually prepared at SDS and provided to District Drug Stores (DDS).

The exercise of preparing the standard patient-wise boxes is done at the NTEP DDS under the guidance and supervision of the District TB Officer (DTO). In such cases, drugs to the district will be supplied in loose form through Nikshay Aushadhi.

Resources

• Guidelines for Programmatic Management of Drug-resistant Tuberculosis in India, March 2021.