Download WHO Collaborating Centre in Tuberculosis Trainin

WHO Collaborating Centre in Tuberculosis Training
National Institute of Tuberculosis and Respiratory Diseases has been designated by
the WHO as a WHO Collaborating Centre in Tuberculosis Training on 06 November
2014 (WHOCC No. IND-128)
The NITRD-WHO CC was opened on World TB Day 2015 by Dr. Jagdish Prasad, Director
General of Health Services (GOI), Dr. Md. Khurshid Alam Hyder, Regional Adviser,
Tuberculosis, WHO-SEARO and Dr Sreenivas A.N., National Program Officer-TB, WHO
India.
Dr. Rohit Sarin, Director, NITRD, is the head of this Centre and the faculty from the
different clinical, laboratory and public health departments of the Institute are participating
members. WHO would be the technical partner for all activities carried out under the
WHOCC. The current designation is for a period of four years.
There are two key components to the NITRD-WHO collaborative activities:
I.
Human resource development and dissemination of knowledge and skills in TB Control
II. Participation in research to contribute to WHO’s evidence based strategies.
As part of this WHOCC, NITRD would enhance its existing training activities and take a
lead role in conducting training programs on various aspects of TB on a regular basis, both
for India and the Region. Addressing training needs of the Region would be an important
objective of this Centre’s activities.
A wide range of TB training programs would be offered under this venture including:
i)
Clinical management of Drug resistant TB (DR-TB)
ii)
Programmatic management of DR-TB
iii)
HIV-TB case management
iv)
Airborne infection control and
v)
Workshops on other diverse aspects of TB and TB control
Basic and advanced workshops in mycobacteriological laboratory methods would be a
distinctive activity under this collaboration. The laboratory trainings would cover the entire
breadth of TB diagnostics including microscopy, solid and liquid culture techniques (for
both first and second line anti-TB drugs) and even latest molecular diagnostic methods like
LPA and Cartridge based Nucleic Acid Tests. Training programs for different cadres for
health care workers would be provided, tailoring to the needs of the trainees. NITRD would
also undertake research focussed on development of novel rapid tests for diagnosis of TB,
MDR-TB and XDR-TB as part of the WHO collaborative activities.
Schedules of different training programs planned at NITRD under this WHO CC are given
in the ‘NITRD-WHOCC Training Schedules’ booklet.
Opening of the WHO Collaborating Centre in Tuberculosis
Training at NITRD on World TB Day 2015
Unveiling of the plaque by Dr. Jagdish Prasad, Director General of Health Services (GOI), Dr
Md. Khurshid Alam Hyder, Regional Adviser, Tuberculosis, WHO-SEARO and
Dr Sreenivas A.N., National Program Officer- TB, WHO India
2 Table of Contents
1. About NITRD-WHOCC in TB Training ........................................................................................1
2. Clinical Management Course on Drug Resistant TB................................................................. 3
3. Training in programmatic management of drug resistant TB ........................................... 6
4. Laboratory Training on ZN Smear Microscopy........................................................................... 9
5. Laboratory Training on LJ Culture and DST ............................................................................. 11
6. Laboratory Training on Detection, Identification and Drug Susceptibility
Testing of M.tb by MGIT -960 ........................................................................................................... 16
7. Practical Course on the Rapid Molecular Detection of M. Tb and
its Resistance to Isoniazid and Rifampin by PCR-based Line Probe Assay................... 20
8. Training on HIV-TB on new National TB guidelines ……………………………….27
9. Program for Training on Childhood Tuberculosis…………………………………………29 10. Air Born Infection Control Training/ Workshop ……………………………………30
3 National Institute of Tuberculosis and Respiratory Diseases has
been designated by the WHO as a WHO Collaborating Centre in
Tuberculosis Training on 06 November 2014 (WHOCC No. IND-128)
Dr. Rohit Sarin, Director, NITRD, is the head of this Centre and the faculty from the
different clinical, laboratory and public health departments of the Institute are
participating members. WHO would be the technical partner for all activities carried
out under the WHOCC. The current designation is for a period of four years.
There are two key components to the NITRD-WHO collaborative activities:
I.
Human resource development and dissemination of knowledge and skills in TB
Control
Participation in research to contribute to WHO’s evidence based strategies.
II.
As part of this WHOCC, NITRD would enhance its existing training activities and take
a lead role in conducting training programs on various aspects of TB on a regular
basis, both for India and the Region. Addressing training needs of the Region would
be an important objective of this Centre’s activities.
A wide range of TB training programs would be offered under this venture including:
i)
ii)
iii)
iv)
v)
Clinical management of Drug resistant TB (DR-TB)
Programmatic management of DR-TB
HIV-TB case management
Airborne infection control and
Workshops on other diverse aspects of TB and TB control
4 Basic and advanced workshops in mycobacteriological laboratory methods would be
a distinctive activity under this collaboration. The laboratory trainings would cover the
entire breadth of TB diagnostics including microscopy, solid and liquid culture
techniques (for both first and second line anti-TB drugs) and even latest molecular
diagnostic methods like LPA and Cartridge based Nucleic Acid Tests. Training
programs for different cadres for health care workers would be provided, tailoring to
the needs of the trainees. NITRD would also undertake research focussed on
development of novel rapid tests for diagnosis of TB, MDR-TB and XDR-TB as part
of the WHO collaborative activities.
5 Clinical Management Course on Drug Resistant TB
Duration :
2 weeks
Method :
Lectures + field visits + ward visits + module discussion*
Day 1
Introduction to course
Pretest Questionnaire
Orientation about NITRD by visit to various departments (?)
Lecture on Epidemiology of TB, MDR-TB, RNTCP structure in India
Introduction about RNTCP: implementation aspects - Deptt of Epidemiology
Day 2
Recap of the previous day
FN: Laboratory visit – discussion and demonstration of LJ Media, MGIT, LPA, Gene
Xpert etc
AN: Lecture on Bacteriological mechanism of Drug Resistance eg.
Mitchinson hypothesis, population hypothesis etc.: by Clinician
Day 3
Recap of the previous day
FN :
Lecture: How MDR-TB develops, clinical & operational cause etc.
Lecture: How to design MDR-TB regimen
AN : Make round of MDR Ward
Case discussion of 1/2 cases
* The WHO PMDT modules would be referred to for clarification on different issues
in drug resistant TB
6 Day 4
Recap of the previous day
FN:
Lecture ; How to design XDR-TB regimen
Lecture: Mode of action and ADR of MDR/XDR-TB Drugs
AN: Lecture: Introduction to PMDT
Visit to PMDT site of NITRD
Day 5
Recap of the previous day
FN: Field visit to PMDT
Discussion + feed back
AN: lecture on MDR-TB in special situations
Lecture on MDR-TB in children
(Saturday / Sunday: OFF)
Day 6
Recap of the previous day
FN:
Lecture on HIV-TB
Palliative therapy in MDR / XDR-TB
AN:
Case studies of MDR / XDR-TB: interactive case demonstration
Day 7
Recap of the previous day
FN:
OPD
AN:
Case studies non-TB diseases mimicking MDR-TB
7 Day 8
Recap of the previous day
FN:
Ward Round and discussion of cases
AN:
Lecture on infection control
Visit for new MDR-Ward
Day -9
Recap of the previous day
FN:
Ward Round and discussion of cases
AN:
Lecture: Role of surgery in MDR/ XDR-TB
Day-10
Recap of the previous day
FN:
Country presentation
Post test
Lunch
AN:
Discussion on pre and post test
Valedictory
8 Training in Programmatic Management of Drug Resistant TB
Duration: Two weeks
Day 1
9.00am
:
Welcome & Introduction to the institute
10.30 am
:
RNTCP –Introduction to Indian TB program
1.00pm
:
Break for lunch
2.00pm
:
WHO Module A-Introduction to PMDT
Day 2
9.00am
:
Recap day 1
9.30am
:
WHO Module A-Introduction to PMDT
11.00am :
:
WHO Modules B – Detect cases of MDR –TB
1.00pm
:
Break for lunch
2.00pm
:
WHO Modules B – Detect cases of MDR –TB
Day 3
9.00am
:
Recap day 2
9.30am
:
Interaction for microbiological aspects regarding MDR TB
National Reference Laboratory visit
To be planned by the department of microbiology
1.00pm
:
Break for lunch
2.00Pm
:
WHO Module C –Treat MDR patient
Day 4
9.00am
:
Recap day 3
9.30am
:
Continue WHO Module C –Treat MDR patient
1.00pm
:
Break for lunch
9 2.00pm
:
Continue WHO Module C –Treat MDR patient
4.00pm
:
Lecture on Air borne infection
Day 5
9.00am
:
Recap day 4
9.30am
:
Visit to MDR Ward
Case study of MDR patients
1.00pm
:
Break for lunch
2.00pm
:
WHO module -D Inform Patients about MDR-TB
Day 6
9.00am
9.30 am
:
:
Recap day 5
Visit to field
For decentralized patients
DOTS observation
1.00pm
:
Break for lunch
2.00pm
:
Discussion of field visit
3.00pm
:
Lecture – PMDT-NITRD experience
Day 7
9.00am
:
Recap day 6
9.30am
:
Visit to ICTC & ART centre
Issues in MDR- TB in HIV patients
1.00pm
:
Break for lunch
2.00pm
:
Observer for the Review panel meeting of the DR centre
Interaction with Review panel
4.00pm
:
lecture-ADR in MDR –TB treatment
10 Day 8
9.00am
:
Recap day 7
9.30am
:
Visit to DR-Centre and interaction with DTO
:
Surgery in MDR-TB
1.00pm
:
Break for lunch
2.00Pm
:
WHO module -E Continuing treatment
12.00pm
`
Day 9
9.00am
:
Recap day 8
9.30am
:
Visit to field
Home visit to MDR patient and other issues
1.00pm
:
Break for lunch
2.00pm
:
MDR – TB in Children
4.00 pm
:
Lecture on Ethics and palliation in MDR-TB
Day 10
9.30am
:
Country presentation by participants
11.000am
:
Parking Lot
12.30pm
:
Valedictory
- Meet the expert session to be adjusted as per the need of the training group
- Role plays to be added during the training as per requirement
11 Laboratory Training on ZN Smear Microscopy
Duration : 4 days
Time from
Time
Description
Day 1
8.00 AM
9.00 AM
8.30 AM
10.00 AM
Registration
Welcome & Introductions,
Workshop Goals, Objectives
10.00 AM
10:00
11:30
12.30PM
1.00PM
2.00PM
3.00PM
10.30 AM
11:30
12:30
1.00PM
2.00PM
3.00PM
4.00PM
Pre-test
Tea break
Smear preparation
Smear staining
Lunch
Smear examination
Rechecking of results
4.00PM
4.30PM
Daily evaluation
9.00 AM
10.00 AM
10.00 AM
10.30 AM
Panel Testing
Panel Testing (contd)
10:30
11:30
11:30
12:30
Tea break
Rechecking of panel slides
12.30PM
1.00PM
Over view of panel slides preparation
1.00PM
2.00PM
2.00PM
3.00PM
Lunch
3.00PM
4.00PM
Overview of External Quality
Assessment of ZN microscopy
4.00PM
4.30PM
Daily evaluation
Day 2
Basics of the Quality System
Concept ZN microscopy
12 Day 3
8.00 AM
9.00 AM
8.30 AM
10.00 AM
10.00 AM
10.30 AM
10:00
11:30
12.30PM
11:30
12:30
1.00PM
Tea break
Smear examination
Smear examination rechecking
1.00PM
2.00PM
2.00PM
3.00PM
Lunch
Basics of the Quality System
Concept
3.00PM
4.00PM
Overview of External Quality
Assessment
4.00PM
4.30PM
Daily evaluation
9.00 AM
10.00 AM
Preparation of panel slides
10.00 AM
10.30 AM
10:30
11:30
Tea break
Staining of panel slides
11:30
12:30
12.30PM
1.00PM
2.00PM
1.00PM
2.00PM
3.00PM
Exercise on sample collection in
OPD
Smear preparion on site
Day 4
Smear examination of panel slides
Discussion of slides
Lunch
Planning and Organizing External
Quality Assessment Scheme
3.00PM
4.00PM
Problem-Oriented Supervision and
Problem Solving
4.00PM
4.30PM
4.30PM
5.00PM
Daily evaluation
Valedictory
13 Laboratory Training on LJ Culture and DST
Duration : 10 days
Time from
Time upto
Description
Day 1
8.00 AM
9.00 AM
8.30 AM
10.00 AM
Registration
Welcome & Introductions,
Workshop Goals, Objectives
10.00 AM
10:00
11:30
12.30PM
1.00PM
2.00PM
10.30 AM
11:30
12:30
1.00PM
2.00PM
3.00PM
3.00PM
4.00PM
4.00PM
4.30PM
Pre-test
Tea break
Introduction to Mycobacterium
specimen collection
Lunch
Hands on in homogenization of
samples
Hands on indigestion and
decontamination procedures
Daily evaluation
9.00 AM
10.00 AM
10.00 AM
10.30 AM
10:30
11:30
11:30
12:30
12.30PM
1.00PM
1.00PM
2.00PM
2.00PM
3.00PM
Hands on in bottling of LJ media
continued
Lunch
Hands on in inoculation procedures
3.00PM
4.00PM
Hands on in incubation procedures
4.00PM
4.30PM
Daily evaluation
Day 2
Hands on in preparation of LJ culture
media
Hands on in Preparation of LJ culture
media continued
Tea break
Hands on in bottling of LJ media
14 Day 3
9.00 AM
10.00 AM
Culture readings
10.00 AM
10.30 AM
Culture reading contd
10:00
11:30
11:30
12:30
12.30PM
1.00PM
1.00PM
2.00PM
2.00PM
3.00PM
Tea break
Culture identification, Niacin &
Nitrate test
Culture identification contd Niacin
& Nitrate test
Lunch
Culture identification contd HRCT
& SQCT
3.00PM
4.00PM
Culture identification contd HRCT
& SQCT
4.00PM
4.30PM
Daily evaluation
9.00 AM
10.00 AM
10.00 AM
10.30 AM
10:30
11:30
Biosafety practice in the
laboratory
Introduction with essential
equipments: uses and routine
maintenance
Tea break
11:30
12:30
12.30PM
1.00PM
1.00PM
2.00PM
2.00PM
3.00PM
3.00PM
4.00PM
4.00PM
4.30PM
Day 4
Required equipments, supplies,
reagents and sterilization of
materials to be used. Biosafety
and working area
Preparation of materials and
reagents contd
Lunch
Quality control must be applied to:
Laboratory arrangement,
equipment, collection and
transport of specimens, handling
of specimens, stains, reagents
and media
Quality control must be applied
contd
Daily evaluation
15 Day 5
9.00 AM
10.00 AM
Care and maintenance of essential
equipment
Bacterial suspension procedure details for
the proportion method standard
Tea break
Preparation of mcfarland nephelometer
barium sulfate
Standard no.1 (paik, g. 1980)
Preparation of loop for Inoculation for DST –
Loop method
Lunch
DST by Proportion method: Preparation of
inoculum & dilutions (loop method)
10.00 AM
10.30 AM
10:00
11:30
11:30
12:30
12.30PM
1.00PM
1.00PM
2.00PM
2.00PM
3.00PM
3.00PM
4.00PM
Incubation and reading, interpretation of
tests
4.00PM
4.30PM
Daily evaluation
9.00 AM
10.00 AM
10.00 AM
10.30 AM
Identification tests, by Susceptibility to pnitrobenzoic acid (PNB)
2) Niacin test
3) catalase activity at 680C/pH 7.
Tea break
Day 6 Monday
Preparation of drug stock solutions for 1
10:30
11:30
line ATT for proportion method
11:30
12:30
Preparation of drug stock solutions for 1
st
st
line ATT for proportion method cotd
12.30PM
1.00PM
Preparation of drug stock solutions for 1
st
line ATT for proportion method cotd
1.00PM
2.00PM
2.00PM
3.00PM
Lunch
preparation of drug containing media for
st
proportion method dst for 1 line ATT drugs
3.00PM
4.00PM
Preparation of drug media contd
4.00PM
4.30PM
Daily evaluation
16 Day 7
8.00 AM
8.30 AM
Preparation of drug stock solutions for 2
ATT for proportion method cotd
9.00 AM
10.00 AM
Preparation of drug stock solutions for 2
nd
line
nd
line
nd
line
nd
line
nd
line
ATT for proportion method cotd
10.00 AM
10.30 AM
Preparation of drug stock solutions for 2
ATT cotd
10:30
11:00
11:00
12:30
Tea break
Preparation of drug stock solutions for 2
ATT for proportion method cotd
12.30PM
1.00PM
Preparation of drug stock solutions for 2
1.00PM
2.00PM
2.00PM
3.00PM
ATT cotd
Lunch
preparation of drug containing media for
nd
proportion method dst for 2 line ATT drugs
3.00PM
4.00PM
4.00PM
4.30PM
preparation of drug containing media for
nd
proportion method dst for 2 line ATT drugs
contd
Daily evaluation
9.00 AM
10.00 AM
Preparation of drug stock solutions for 2
Day 8
nd
line
ATT for absolute concentration method
nd
10.00 AM
10.30 AM
line
ATT for absolute concentration method contd
10:30
11:00
Tea Break
11:30
12:30
12.30PM
1.00PM
1.00PM
2.00PM
2.00PM
3.00PM
line
ATT for absolute concentration method contd
nd
Preparation of drug stock solutions for 2
line
ATT for absolute concentration method contd
Lunch
nd
Preparation of drug stock solutions for 2
line
ATT for absolute concentration method cotd
3.00PM
4.00PM
line
ATT for absolute concentration method cotd
4.00PM
4.30PM
Daily evaluation
Preparation of drug stock solutions for 2
Preparation of drug stock solutions for 2
Preparation of drug stock solutions for 2
nd
nd
17 Day 9
9.00 AM
10.00 AM
Quality control of equipments, drugs, media
10.00 AM
10.30 AM
10:30
11:00
11:00
12:30
12.30PM
1.00PM
1.00PM
2.00PM
2.00PM
3.00PM
Quality control of equipments, drugs, media
contd
Tea break
Quality control of equipments, drugs, media
contd
Quality control of equipments, drugs, media
contd
Lunch
Quality control handling of specimens Stains,
reagents and media, bacteriological methods
3.00PM
4.00PM
4.00PM
4.30PM
9.00 AM
10.00 AM
10.00 AM
10.30 AM
10:30
11:00
11:30
12:30
12.30PM
1.00PM
1.00PM
2.00PM
2.00PM
3.00PM
3.00PM
4.00PM
Quality improvement, proficiency testing
contd
4.00PM
4.30 PM
4.30PM
5.00PM
Daily evaluation
Valedictory
Quality control handling of specimens Stains,
reagents and media, bacteriological methods
contd
Daily evaluation
Day 10
Quality control Adequately trained, interested
and committed staff Common-sense use of
practical procedures a willingness to admit
and rectify mistakes effective communication
Quality control Adequately trained, interested
and committed staff Common-sense use of
practical procedures a willingness to admit
and rectify mistakes effective communication
contd.
Tea Break
Quality control digestion and
decontamination
Quality control digestion and
decontamination contd
Lunch
Quality improvement, proficiency testing
18 Laboratory Training on Detection, Identification and Drug
Susceptibility Testing of Mycobacterium tuberculosis by
MGIT -960
Duration : 2 weeks
Day 1
9 – 9:15 am – Welcome and Introductions
9:15 – 9:45 am – Course Pre-test
9:45 – 10:15 am – Introduction to TB and the course
10:15 – 10:35 am – Tea Break
10:35 – 11:45 pm –Biosafety in the TB laboratory (General and BSL2 & 3)
11:45 – 12:30 pm - Essential equipment: use and routine maintenance
12:30 – 1:30 pm – Lunch
1:30 - 5:00 pm – Laboratory split sessions
1) PPE
2) BSC
3) Liquid handling (assessment of skills, taped work areas,
colored water, pouring pipetting)
Day 2
8:30 – 9:30 am – Reagents, media, QC & Troubleshooting
9:30 – 10:00 am – Tea break
10:00 – 12:30 pm – Laboratory preparation of NaOH, NaCitrate, PBS pH6.8
12:30 – 1:30 pm – Lunch
1:30 – 2:15 pm – Specimen collection, receipt and accessioning
2:15 – 5:00 pm – Laboratory session on specimen receipt, log in, work sheets and
continue practice pipetting
(Provide copies of specimen processing SOP and job aid as homework reading)
Day 3
19 8:30 – 10:00 am – Specimen processing and inoculation of solid and liquid media
10:00 – 10:30 am – Tea break
10:30 – 11:30 am – Introduction to MGIT 960 system and incubation of vials
11:30 – 12:00 pm – Disinfectants, spills and waste
management 12:00 – 12:30 pm – Spill Kit Assembly
12:30 – 1:30 pm – Lunch
1:30 – 5:00 pm – Laboratory split sessions:
1) Demonstration of specimen processing, inoculation and incubation (Two
work-stations, each with one facilitator processing, one facilitator providing
explanations and 2 – 3 participants observing)
2) Demonstration of the MGIT 960 Instrument
Day 4
8:30am – 5:00pm – Hands-on processing of specimens by participants
(Simulated or patient specimens)
Participants will work in groups of two. One participant will process two
sputum specimens and two blanks in the morning, and the other will process
the same number of specimens in the afternoon. Participants not processing
will be observing their team mate. 5 work stations will be used for 5
participants at a time.
Day 5
8:30 – 9:30 am – Debrief from specimen processing – Cabbage ball
9:30 – 10:30 am – Growth detection on solid media
10:30 – 11:00 am – Tea Break
11:00 – 11:30 am – Growth detection in the MGIT 960
11:30 – 12:30 pm – Recognizing false-positive specimens
12:30 – 1:30 pm – Lunch
20 1:30 – 5:00 pm – Laboratory session – Growth on LJ, MGIT, BAP, Smears
Day 6
8:30 – 10:00 am – Identification methods for the M. tuberculosis
complex 10:00 – 10:30 am – Tea Break
10:30 – 12:30 am – Use of Capilia or SD Bioline for ID
12:30 – 1:30 pm – Lunch
1:30 – 2:30 pm – Molecular Biology Basics and line probe assays, MTBDR DVD
2:30 – 3:30 pm – PCR energizers
3:30 pm- 4:30 pm - Laboratory set up PCR for line probe
4:30 – 5:00 pm – PCR contamination control and Quality control
Day 7
8:30 – 9:30 am – Recording and reporting culture
results 9:30 – 10:30 am Quality assurance / Quality
indicators 10:30 – 11:00 am Tea break
11:00 – 12:30 pm Laboratory Layout exercise
12:30 – 1:30 pm – Lunch
1:30 – 2:30 pm – Laboratory Spill activities – in BSC, outside BSC, in MGIT 960
2:30 – 5:00 pm – Laboratory split session – MGIT QC and growth detection checks
Day 8
8:30 – 9:30 am – Introduction to drug susceptibility testing
9:30 – 10:15 am –Isolate submission, processing and rejection criteria for
DST 10:15 - 10:45 am – Tea break
21 10:45 – 12:00 am - Principle of the MGIT960 DST system, preparation of drug vials
and inoculum, inoculation of vials, introduction of vials to the
instrument
12:00 – 1:00 pm – Lunch
1:30 – 4:30 pm – Laboratory split session (2 groups) – Demonstration of MGIT 960
DST setting up
4:30 pm – 5.00 pm Questions on MGIT DST
Day 9
8:30 – 9:45 am – Reading and reporting of MGIT 960 DST
9:45 – 10:15 am – Tea break
10:15 – 12:45 pm – Laboratory activities on MGIT DST set up
12:45 – 1:30 pm – Lunch
1:30 – 2:30 pm – QC of MGIT 960 DST and troubleshooting
2:30 – 5:00 pm – Laboratory activities on MGIT DST set up
Day 10
8:30 – 10:00 am – Descriptions of in-country labs (photos, layouts, etc.
10:00 – 10:30 am – Tea Break
10:30- 11:30 am - MGIT DST checks and reading
11:30 – 12:00 pm – Post course test, Participant course evaluation
12:00 – 12:30 pm – Presentation of course certificates and closing ceremony
12:30 – 1:30 pm – Lunch
22 Practical Course on the Rapid Molecular Detection of
M. tuberculosis and its Resistance to Isoniazid and Rifampin by
PCR-based Line Probe Assay
Duration : 5 days
Day 1
Lectures:
08:00-08:15 am Greeting of participants, course agenda
08:15-08:30 am Introduction of participants and facilitators
08:30-08:45 am Pre-course test
08:45-09:30 am Biosafety I.: biosafety in the TB laboratory 09:3010:00 am Biosafety II: disinfectants, spills, waste management
10:00-10:15 am Tea break
10:30-11:00 am Biosafety cabinet
Laboratory training:
11:00-01:00 pm Liquid handling exercises
01:00-02:00 pm Lunch break
02:000-2:30 pm Specimen preparation area (all participants)
02:30-05:00 pm Demonstration of specimen preparation for the Genotype MTBDR
Day 2
Lectures:
08:30-09:15 am Essential instruments overview (set up, calibration,
09:15-10:00 am maintenance) Specimen preparation for the Genotype MTBDR
10:00-10:15 am
Tea break
23 Laboratory training:
10:15-12:00 pm Sequence for donning and removing of personal protective
equipment (PPE), spill exercise (rotation)
Group A starts with PPE
Group B starts with spill kit preparation, spill exercise
12:00-01:00 pm Lunch break
01:00-01:15 pm Reagent preparation area (all participants)
01:15-02:00 pm Demonstration
of reagent preparation and adding of DNA
(amplification)
02:00-50:00 pm Hands on training on specimen preparation for the Genotype
MTBDR
Day 3
Lecture:
08:30-09:30 am Reagent preparation for the Genotype MTBDR
09:30-11:00 am Group A: Molecular biology basics
11:00-11:15 am Tea break
11:15-12:30 pm Group B: Molecular biology basics
Laboratory training:
09:30-11:00 am Group B: Reagent preparation for the Genotype MTBDR
(hands on)
11:00-11:15 am Tea break
11:15-12:30 pm Group A: Reagent preparation for the Genotype MTBDR
(hands on)
24 12:30-01:30 pm Lunch break
01:30-02:00 pm Reagent preparation area (all participants) 02:0004:30 pm Demonstration of hybridization of amplified products
04:30-05:00 pm PCR laboratory layout exercise (handing out homework materials,
explaining task)
Day 4
Lecture:
08:30-10:00 am Hybridization of amplified products
10:00-11:15 am Group A: Molecular mechanisms of INH and RMP drug resistance
11:15-11:30 am Tea break
11:30-1:00 pm
Group A: Trouble shooting, contamination control
01:00-02:00 pm Lunch break
02:00-03:15 pm Group B: Molecular mechanisms of INH and RMP drug resistance
03:15-03:30 pm Tea break
03:30-05:00 pm Group B: Trouble shooting and contamination control
Laboratory training:
10:00-01:00 pm Group B: Hybridization of amplified products (hands on)
01:00-02:00 pm Lunch break
02:00-05:00 pm Group A: Hybridization of amplified products (hands on)
25 Day 5
08:30-09:30 am Interpretation of results
09:30-10:30 pm Interpretation of participant`s results
10:30-10:45 am Tea break
11:45-12:15 pm Quality control of line probe assay
12:15 -1:00 pm
Lunch
01:00- 02:00 pm Introduction to the “Book of life SOPs”
02:00-02.30 pm Organization of work flow
03:00-03:30 pm Post-course test and course evaluation
02:30-03:00 pm Presentation of certificates, closing
26 Training on HIV-TB on new National TB guidelines
( to be undertaken in collaboration with RNTCP and NACO)
Duration : 2 days
Day 1
Time
09:15--09:30
Topic
Pre-test and self-assessment of participants knowledge on training topics
Training overview
09:40--10:00
TB-HIV collaborative activities
Training objectives and curriculum plan
10:00--11:00
Aetiology, Pathogenesis and Natural Progression of TB Infection
11:00--11:15
Tea Break
11:15--12:15
Rationale for moving to Daily Regimen and Basics of daily ATT
12:15--13:15
Adverse Drug Reactions and Drug – Drug interactions
13:15--14:00
Lunch
14:00--16:45
(With Tea
break)
Operational guidelines on management of TB in PLHIV at ART Centres
16:45--17:30
IPT: Rationale and Guidelines
08:30--09:00
Revision of Day one:
Recap and clarifying doubts from day one.
09:00--12:00
(With tea
break)
Recording & Reporting Tools
12:00--13:15
Need for Airborne Infection Control & PPE (Personal Protective Equipment)
13:15--14:00
Lunch
14:00--15:45
Managerial, Administrative & Environmental measures of AIC
15:45--16:00
Tea Break
16:00--17:00
Revised ART initiation guidelines and SACEP referral mechanism
17:00--17:15
Planning for field visit:
For daily ATT
For IPT
27 Facility risk assessment tool discussed on site
Day 3
8:30--11:30
(With tea M&E Hands on Training break)
11:30--14:00
Field visit to ART centre
14:00--14:30
Lunch
14:30--15:00
Post-test /self-assessment / end of training assessment
28 Program on Training Childhood Tuberculosis
Duration : 2 days
DAY -1
Time
0900-1100
Topic
Welcome and Inauguration (10min)
Defining the magnitude of Problem
Natural History of Disease
1100-1115 TEA
1115-1300 Pulm TB Diagnostic Part 1
(Symptoms, Radiology, TST)
1300-1400 LUNCH
1400-1600 TB Diagnostic Part II- Microbiology
Newer Rapid tests (GeneXpert, LPA, MGIT), MOTT/M.tb
Hands-on –Lab visit
1600-1615 TEA
1615-1800
Pulm TB Diagnostic algorithm case based
DAY-2
0900-1100
Lymph node TB Diagnostics
Pleural TB Diagnostics
1100-1115 TEA
1115-1300 CNS TB Diagnostics
Abdominal TB Diagnostics
1300-1400
LUNCH
1400-1600
Treatment of TB- RECENT TREATMENT GUIDELINES
Monitoring of Treatment-Defining response & Non response
1600-1615
Management of adverse effect
TEA
1615-1800
Drug resistant TB When to suspect and how to manage MDR and XDRSpecial Conditions Neonate of mother with TB
Special Conditions- HIV TB
Prevention of TB
29 Air Born Infection Control Training/ Workshop
Duration ---- 10 days
Evaluation -----
Pre- Test, Post Test and feedback Performa
Programme Schedule
Time
Topic
DAY (1)
8:30 am to 9:00 am
Registration
9:00 am to 10:00 am
Pre- Test
10:00 to 10:30 am
11:00 am to 11:40
DAY (2)
Inauguration+ Tea
1. Air Dynamics
2. Bio-aerosol behaviour
3. National Air borne Infection control guidelines
1. Risk Assessment of air bone infections
Risk assessment of infrastructure, Person
TB Burden in India
TB in HCW with prevention
After noon
2. Hierarchy of Infection control
Administrative
Environmental
Personal Protection
DAY 3.
Ventilation Designs
Natural
Mechanical
Mix Modes
Afternoon
Advantages with
Practicality of each
each
Visit to Demonstrate ventilation designs
Wd.6
MDR Wd.
Private Wd.
Bio-safety labs
DAY 4.
Surgical Masks VS respirators
Fir testing
Comfort
30 Communication
Demonstration
Fit testing exercises
DAY 5.
Air velocity and measuring air changes
Smoke test
ACH calculation
Practical Demonstration
Group work
DAYS 6, 7
DAY 8
After noon
DAY 9
Morning
Break
UVGI
Equipment types
Installation
Maintenance
Impact
Effectiveness
Practical Demonstration of UUGI
Bio-Safety Labs Cabinets
Class -
1 Infrastructure with
2 safety of product and
3 person.
Movement of air flow in all
Afternoon
DAY 10.

Demonstration of BSL-1,2,3 labs
BM Waste Introduction
New Guidelines
Percales
Categorization
Legal Implications
Visit to wards
 BMW plant
 Observations
 Presentation
31 32