Interaction of STLS with TB Patient Care Ecosystem

The Senior Tuberculosis Laboratory Supervisor (STLS) interacts with the TB patient care ecosystem from the time a presumptive TB case is identified, examined, diagnosed, notified, and put on anti-tuberculosis treatment till the completion of treatment.

The key interactions include:

• Coordination with the Medical Officer (MO) of various dispensaries and other health establishments to ensure referral of the presumptive TB cases to the Designated Microscopy Centers (DMCs) and Nucleic acid amplification test (NAAT) laboratories for diagnosis of TB and DR-TB.
• Coordination with laboratory technicians of the DMCs and NAAT laboratories for results of TB diagnosis, follow-up, and sending samples for further testing to the designated Intermediate Reference laboratories (IRLs).
  • STLS is also responsible for providing monthly supply of staining regents, consumables, NAAT cartridges and chips to the LTs of the DMC and NAAT Laboratories.  
  • STLS is the key person for ensuring quality assured TB diagnosis in the district. This is done by performing activities like On-site evaluation (OSE) visits, Random Blinded Rechecking (RBRC) of smears and providing quality assured staining reagents to the DMCs. 
• Coordination with Senior Treatment Supervisor (STS) to ensure that all TB patient diagnosed are initiated on treatment.
• Coordination with STS and PMDT Coordinator in updation of relevant NTEP records, line-list of presumptive DR-TB patients and preparation of Quarterly Reports
• The STLS interacts with the health care staff to facilitate change management with respect to use of Information and Communications Technology (ICT) and Ni-kshay tools for concerned data entry, validation & its use for public health action.
  • STLS ensures that the laboratory results related to diagnosis and subsequent follow-ups are updated by the LTs in a timely manner.
• STLS constantly Interacts with the District Drug Store (DDS), pharmacist and District TB Centre (DTC) to ensure adequate supply of CBNAAT cartridges and Truenat Chips to the NAAT laboratories and also keeps a track of transaction related to receipt and dispatch of these Cartridges and Chips.
  • This process is undertaken by the use of Ni-kshay Aushadhi. SLTS uses Ni-kshay Aushadhi for request generation, inventory management, and issue of cartridges and Chips to NAAT laboratories.
• The STLS supports assigning treatment support centers and treatment supporters for the patient. The treatment supporters may be community volunteers accessible, willing, and acceptable to the patient and who can be accountable to the health system. These include Anganwadi workers, dais, teachers, panchayat leaders, religious leaders, and others.
• The STLS coordinates with District TB Officer (DTO) and DTC to conduct monthly and quarterly review meetings.
• The STLS is crucial in undertaking active case finding activities and  organizing community-based Information, Education and Communication (IEC) activities like patient-provider group interaction meetings and community meetings in coordination with the support of field staff, which includes the ASHA workers, Community Health Officer (CHO), Multipurpose Health Worker (MPHW), and Auxiliary Nursing Midwife (ANM).
• The STLS coordinates with the private health care settings including the standalone laboratories in the districts to ensure that the patients diagnosed in these facilities are notified to the programme and appropriate public health action is taken when required.

Resources

• Training Modules (5-9) for Programme Managers and Medical Officers, NTEP, CTD, MoHFW, GoI, 2020. 

Assessment