1. GENEXPERT MTB/RIF
Presented by:
N.Ramalingam. M.A.,DCA., HE.,
“STOP TB Forum “District
Secretary,
“Master Trainer in SOFT SKILLS,
TB/HIV,DM,LEPROSY etc.
No.110,Kurinji Nagar,
Velisemmandalam,
Cuddalore -607001
Tamil Nadu
Mobile: 9443537619
Email:
ramalingam_n1953@yahoo.com

2. Advocacy efforts taken
for
TB care and control

3. WHO estimates that only 66% of incident TB cases are
detected.
This translates into 3 million NEW TB cases being
missed every year.
Major efforts are needed to ensure all cases are
detected, notified and treated.
In this connection:
1.Incresed use of new diagnostic is ensuring that
significantly more TB patients are to be correctly
diagnosed.
2.TB diagnostics and laboratory to be strengthening.

4. 3.Laboratory confirmation of TB and Drug
resistance is key to ensuring that individuals with
TB signs and symptoms are correctly diagnosed and
treated. In 2013, 58% of the 4.9 million Pulmonary
TB patients notified Globally were bacteriologically
confirmed via a WHO recommended test, including
rapid tests such as Xpert MTB/RIF.
In late 2013 WHO expanded its
recommendations on the use of Xpert MTB/RIF to
include the diagnosis of TB in children and some
forms Extra pulmonary TB.
By June 2014, 108 countries with access to Xpert
MTB/RIF is concessional prices had started to use
the technology, and more than one million text
cartridge were being procured each quarter.

5. MY ADVOVACY APPROCH
In Tamil Nadu, such advanced diagnostic
instruments have been provided by the Tamil Nadu
Govt. only few laboratories in the state and it is
being supplied only where there is Medical
Colleges districts.
In my Cuddalore District, there is no Medical
Colleges.
So I taken up this issue as a challenge and must
be got the machine to the District TB Centre, Govt.
Head Quarters Hospital Cuddalore, since there is
no Medical Collages and advocates for the same.

6. As a first step, I approached the Chief
Minister of Tamil Nadu through Chief
Minister’s special cell , St.George Forte,
Chennai with a request to supply ONE
GENEXPERT MACHINE TO DISTRICT TB
CENTRE, GOVT. HEAD QUARTERS
HOSPITAL, CUDDALORE, FOR THE BENFIT
OF POOR PEOPLE LIVING IN CUDDALORE
DISTRICT.(Copy of letter enclosed).

7. Second step, I was approached through
letter communication to Health Secretary,
Director of Medical & Rural Health
services, Chennai, Director of Public Health
and Preventive Medicine, Chennai, NRHM
Director ,Chennai and all Medical & Health
Directors with a request to provide one
GENEEXPERT MACHINE TO CUDDALORE
WITH REASANABLE JUSTIFICATIONS.

8. With my repeated requestations and representations to the
Chief Minister of Tamil Nadu and higher authorities of Medical &
Public Health officers in Tamil Nadu, my representation was
accepted by Chief Minister of Tamil Nadu and
sanctioning a Genexpert Machine to Cuddalore
and it was installed at the Cuddalore District TB
Centre Vide ref .No./20/DHS-RNTCP/2015 and it
was informed me by email from Chief Ministers
special cell office, Chennai.
The Joint Director of Medical and rural Health Services & FW ,
Cuddalore District was also informed me about the sanctioning of
GENEXPERT Machine.
Advocacy Training is very well helping me to achieve the
challenge.

9. SUMMARY
• AFTER ATTENDING ADVOCACY
TRAINING AT CHENNAI I HAD
ACHIEVED WITH FERELESS AND
ADVOCACY APPROCH AND GOT
ONE GENEXPERT EQUIPMENT TO
GOVT HEAD QUARTERS HOSPITAL ,
AT DISTRICT TB CENTRE,
CUDDALORE , TAMIL NADU AND IT
WILL BE INSTALLED AND START
OPERATION DURING OCTOBER.
• ADVOCY TRAINING IS VERY USE
FULL ME AND VERY MUCH
THANKS TO PTCC
ADVOCACY TRAINING AT CHENNAI

10. N.RAMALINGAM. MA., DCA., HE.,FACULTY-SOFT SKILL TRAINING
DISTRICT SECRETARY,
No.110, KURINJI NAGAR, VELISEMMANDALAM, CUDDALORE -607001
Mobile9443537619 Email: ramalingam_n1953@yahoo.com
The Hon’ble Chief Minister of Tamil Nadu,
Secretariat,
Fort St. George,
Chennai.
Sir/Amma,
Sub: “STOP TB FORUM CUDDALORE DISTRICT” (Revised National Tuberculosis Control Programme) –
GeneXpert Equipment supply requested to the District Head Quarters Hospital, Cuddalore-Requested-
Regarding.
@@@
I N.RAMALINGAM, DISTRICT SECRETARY OF “STOP TB FORUM CUDDALORE DISTRICT” is invited your kind
attention for consideration to provide GeneXpert equipment to detect and diagnose the TBHIV disease accurately, in
Govt. Head Quarters Hospital, Cuddalore for the benefit of people living in Cuddalore district.
Extensive screening to detect TB among HIV infected and vice versa across the state under the Revised
National Tuberculosis Control Programme(RNTCP) to contain the co-epidemic, has been taken up and the authorities have
been equipped with eight GeneXpert equipments to accurately diagnose the disease. This will make significant
development in facilitating early treatment.
Hitherto, such advanced diagnostic instruments have been provided by few laboratories only. Of the eight,
three of these advances diagnostic equipments, which can detect TB among HIV persons within two hours, have been in
Chennai including the Govt. Hospital of Thoracic Medicine (GHTM) in Tambaram Sanatorium. The remaining five
equipments have been installed at Vellore, Namakkal, Trichi, Madurai and Tirunelveli.
I came to understand that the Govt. had taken up the screening to combat this biggest public health
challenge in connection with the World TB Day-2015 (Observed annually on March 24)
As per official data, Tamil Nadu has reported 84,560 new TB cases in 2014 (out of 71,72,690 persons screened
in the state) and of them 1145 were found to be MDR TB cases.
Now the focus is on prevention, control, treatment and relief of tuberculosis.

11. IN THIS CONNECTION I REQUESTED,
THE HON’BLE CHIEF MINISTER OF TAMIL NADU TO PROVIDE ONE
GENEXPERT DEVICE TO THE GOVT. HEAD QUARTERS HOSPITAL, CUDDLORE
FOR THE BENIFIT OF PEOPLE LIVING IN CUDDALORE DISTRICT WITH RELIEF OF
TUBERCULOSIS.
Yours sincerely,
(N.RAMALINGAM)
Copy to
The Hon’ble Health Minister, Secretariat, Fort St.George Chennai.
The Health Secretary, Secretariat, Fort St.George Chennai.
The Director, Tamil Nadu Health System Project DMS, Complex, Chennai-6
The Director, NRHM, DMS, Complex, Chennai-6
The Director of Medical & Rural Health Services, DMS, Complex, Chennai-
The Director of Public Health & Preventive Medicine, DMS, Complex,
Chennai-6
The District Collector, Cuddalor District for information and necessary
further action.

12. GENEXPERT EQUIPMENT SACTIONED EMAIL LETTER FROM
CHIEF MINISTER SPECIAL CELL TAMIL NADU
• cmcell@tn.gov.in
• To
• ramalingam_n1953@yahoo.com
• Today at 5:38 PM
•
• Your Feedback - 2015/83086/EK what is the status of my existing
petition?
•
Reply from CMCELL –
•
• Accepted, The individual representation has been sent to the Additional
Director of Medical and Rural Health Services and State TB
Officer,Chennai.6. Sanctioning a Gene Expert Machine to Cuddalore, by
the above Directorate. Ii is installed at the Cuddalore District TB Center.
Vide ref No: 20/DHS-RNTCP/2015 Dt: 25.06.2015
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13. FUTURE COURSE OF ACTION FOR TB
CARE AND CONTROL
• "Find TB”.
• “Treat TB”.
• ”Working together to eliminate TB."
• TB is still a life-threatening problem in the World,
despite the declining number of TB cases.
• Anyone can get TB, and our current efforts to
find and treat latent TB infection and TB disease
are not sufficient.
• Misdiagnosis of TB still exists and health care
professionals often do not "think TB."

14. TO FIND TB…..
• Reach the missed cases
• Appoint “ASHA’s” to detect symptomatic cases on
TB as Intensive case detection campaign at Door
to Door steps followed by IEC in all Rural & Urban
areas as Active Search.
• ASHA Should be appointed in all PHCs areas one
ASHA for 1000 pop.
• ASHA’s should focuses on poor, vulnerable and
marginalized groups and populations with limited
or no access to control services.

15. • Intensive case detection campaign should be
done in every 6 months once at the same
areas.
• I am planning to adopt a Urban slum
population in Cuddalore, about 10000 pop. for
screening of TB systematic cases by Active
Search by involving volunteers like NSS
students, TB Forum Members and NGOs etc.
during October2015 on wards

16. • Active Search may be planned once in every 6
months.
• Lab. Investigations may be done with Co-
operation of Govt. RNTCP staff.
• Prior to Survey we are planned to conduct
street corner play with a trained volunteers for
creating awareness about TB and announcing
that the survey to be conducted on the next
day Morning.

17. • The symptomatic cases detected through
active search referred for lab. Investigation to
the nearest DMC.
• After diagnosing as TB we are arranged for
providing DOTS through DOTS PROVIDER as
DOTS (Directly Observed Treatment in Short
Course) at their areas and followed them until
completion of DOTS for 6 months.

18. • This process will be done for three years
continuously.
• After three years may be declared as “NO TB
AREA”
• This process May be Reached the
ELEMINATION STATUS at the particular
ADOPTED Urban Slum Area.