Communicable and Non-Communicable Diseases
The exam tests the dual burden - India's persistent infectious diseases and the rising NCD load - with emphasis on case definitions, first-line treatment and programme reporting.
Communicable diseases
- TB under NTEP: every presumptive TB case gets upfront NAAT (CBNAAT or Truenat); treatment is daily FDC (2 months HRZE, 4 months HRE by weight band); notification on Ni-kshay is mandatory; Ni-kshay Poshan Yojana gives nutrition support by DBT; household contacts are screened and HIV testing offered.
- Leprosy: MDT is free. Paucibacillary disease gets 6 months of monthly rifampicin plus daily dapsone; multibacillary gets 12 months with clofazimine added; a single skin lesion is treated with a single dose of ROM.
- Malaria: falciparum gets ACT plus a single dose of primaquine; vivax gets chloroquine for three days plus primaquine for 14 days. Dengue is transmitted by Aedes aegypti, a day biter; control is larval source reduction, and aspirin is avoided.
Non-communicable diseases
- NPCDCS uses the CBAC form to screen people aged 30 and above for hypertension, diabetes and three common cancers: oral visual inspection, clinical breast examination and VIA for cervix (30–65 years).
Worked example
A 45-year-old with cough for three weeks, evening fever and weight loss: sputum NAAT is positive. Actions are - start weight-band FDC, notify on Ni-kshay, enrol for nutrition DBT, screen household contacts, offer HIV testing and blood sugar screening, and repeat sputum at the end of the intensive phase.
Traps
- Treating only smear-positive patients as notifiable; all TB cases are notified.
- Using ACT for vivax malaria.
- Missing that a single leprosy skin lesion needs only single-dose ROM.