{"presentation":{"slides":[{"elements":[{"x":15.250544662309368,"y":9.677419354838708,"width":80.61002178649238,"height":23.01075268817204,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"

All patients diagnosed as MDR\/RR-TB using various technologies will be evaluated and initiated on an appropriate regimen with eligibility criteria as per the integrated diagnostic and treatment algorithm for DS and DR-TB FQ DST is strongly enocuraged, but DST should not delay treatment initation. <\/span><\/span><\/p>\n\n

\n<\/p>

<\/p>\n

<\/p>\n\n

Once a patient is identified as per the eligibility criteria:<\/span><\/span>
\n <\/p>\n\n

The N\/DDR-TBC committee will initiate treatment with BPaLM or a 9-month shorter oral regimen <\/strong>until Bdq for children under five<\/strong> and Pa for those under 14 <\/strong><\/span>is approved under NTEP.
\n\t <\/li>\n\t
Hospitalization can be arranged <\/strong><\/span>at the N\/DDR-TBC inpatient facility or referred to another facility as needed (see hospitalization criteria in the Guidelines for PMDT in India-2021).<\/li>\n<\/ul>\n"},"subContentId":"50ea1da2-7151-47d3-bd41-ea4fe9c497af","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":14.161220043572985,"y":4.301075268817204,"width":83.00653594771242,"height":89.89247311827957,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
\n\t
Comprehensive counseling will be provided, including educational materials in the local language covering:<\/li>\n<\/ul>\n\n
- Treatment nature and duration<\/p>\n\n
- Details on BPaLM or the 9-month regimen<\/p>\n\n
- Importance of regular treatment<\/p>\n\n
- Potential side effects and drugs to avoid<\/p>\n\n
- Risks of irregular or premature treatment cessation
\n <\/p>\n\n
\n\t
Patients will receive counseling on family planning.
\n\t
\n\t <\/li>\n\t
A patient-specific box containing bottles and strips for the treatment course will be managed by the treatment supporter throughout the treatment period.<\/li>\n<\/ul>\n"},"subContentId":"2d028411-326c-4fb8-be30-959b839e629f","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":3.2679738562091507,"y":2.1438172043010755,"width":10.893246187363834,"height":21.50537634408602,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672bd942d3d27.png","mime":"image\/png","copyright":{"license":"U"},"width":500,"height":500}},"subContentId":"fc29c0ba-07fd-4a52-85e4-8dc5c4565348","metadata":{"contentType":"Image","license":"U","title":"Untitled 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<\/p>\n\n
Since Bdq (Bedaquiline) has a longer half-life, monotherapy can be risky if treatment is interrupted, which can lead to drug resistance<\/strong>
\n <\/p>\n\n
<\/p>\n\n
<\/p>\n\n
<\/p>\n"},"subContentId":"12b56369-11d3-496c-853e-d1d1f215912c","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":13.071895424836601,"y":22.58064516129032,"width":82.78867102396515,"height":75.26881720430107,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
It is essential that all treatment regimens, including BPaLM, are administered under the direct supervision of a trained treatment supporter.
\n <\/p>\n\n
Treatment supporters may include healthcare providers community volunteers, or family members identified by the community health officer (CHO) at the health and wellness center (HWC).
\n <\/p>\n\n
Supporters should receive training from health facility (HF) and TB unit (TU) staff linked to each patient.
\n <\/p>\n\n
The use of suitable digital adherence monitoring technology is recommended, in line with the Guidelines for PMDT in India - 2021.<\/p>\n"},"subContentId":"4106a2d0-32e5-4129-95f9-de490272d16f","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":5.446623093681917,"y":19.301075268817204,"width":5.446623093681917,"height":73.11827956989247,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(255, 171, 78)","borderWidth":"2","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"subContentId":"fca5d0f0-8530-4cf4-8c41-9b59a00614d5","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":7.625272331154684,"y":25.806451612903224,"width":39.97821350762527,"height":64.51612903225806,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
A.
\n
\n
\n
\nB.
\n
\n
\n
\nC.
\n
\n
\n
\nD.<\/strong><\/p>\n"},"subContentId":"64e42d4f-0fc8-47c5-a928-50f04d7e7f1c","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""}],"slideBackgroundSelector":{}},{"elements":[{"x":5.446623093681917,"y":6.451612903225806,"width":89.32461873638344,"height":19.354838709677416,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(249, 206, 149)","borderWidth":"2","borderStyle":"solid","borderColor":"rgb(0, 0, 0)","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"metadata":{"contentType":"Shapes","license":"U"},"subContentId":"9582f04a-9b8e-41fb-b75a-37bccdb2b274"},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":4.357298474945534,"y":4.301075268817204,"width":89.32461873638344,"height":19.354838709677416,"action":{"library":"H5P.Shape 1.0","params":{"shape":{"fillColor":"rgb(254, 201, 132)","borderWidth":"2","borderStyle":"solid","borderColor":"#000","borderRadius":"0"},"type":"rectangle","line":{"borderColor":"#000000","borderWidth":"1","borderStyle":"solid"}},"subContentId":"2ebbbef8-1e4e-4ee3-9737-430695d95349","metadata":{"contentType":"Shapes","license":"U"}},"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false},{"x":6.5359477124183005,"y":32.25806451612903,"width":86.05664488017429,"height":10.75268817204301,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
It is advisable for treatment supporters to accompany the patient or contacts to screening and follow-up visits and coordinate with the clinical staff.<\/p>\n\n
<\/p>\n"},"subContentId":"bb2884e4-69a9-49d3-945b-3a8f0095bc8d","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":6.5359477124183005,"y":8.602150537634408,"width":89.32461873638344,"height":12.903225806451612,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
Observation indicator<\/strong>: Minimum of 80% of doses are to be supervised physically or by digital adherence technologies like medication event reminder monitor [MERM] of 99DOTS. <\/span><\/p>\n"},"subContentId":"f1cc6ed4-b0cd-437b-b87f-cf217dff710c","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":15.250544662309368,"y":49.46236559139785,"width":78.43137254901961,"height":43.01075268817204,"action":{"library":"H5P.AdvancedText 1.1","params":{"text":"
\n\t
Dairy products, calcium supplements, and calcium-containing antacids should be avoided for two hours before and two hours after taking any regimen, as calcium can bind with fluoroquinolones (FQs) and render them ineffective.
\n\t
\n\t <\/li>\n\t
If there is a temporary cessation of the regimen, reintroduction should be considered within one month (30 days) after the patient is reassessed by the N\/DDR-TBC.<\/li>\n<\/ul>\n"},"subContentId":"cdae6ec5-d705-4728-be55-787c6fdd14db","metadata":{"contentType":"Text","license":"U","title":"Untitled Text"}},"alwaysDisplayComments":false,"backgroundOpacity":0,"displayAsButton":false,"buttonSize":"big","goToSlideType":"specified","invisible":false,"solution":""},{"x":4.357298474945534,"y":47.31182795698924,"width":10.893246187363834,"height":21.50537634408602,"action":{"library":"H5P.Image 1.1","params":{"decorative":false,"contentName":"Image","expandImage":"Expand Image","minimizeImage":"Minimize Image","file":{"path":"images\/file-672bd942d3d27.png","mime":"image\/png","copyright":{"license":"U"},"width":500,"height":500}},"metadata":{"contentType":"Image","license":"U","title":"Untitled 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Treatment initiation for MDR/RR-TB cases

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Treatment initiation for MDR/RR-TB cases

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