National Tuberculosis Programme, NEPAL

Tuberculosis (TB) remains as a public health problem in Nepal, as it is responsible for ill health among thousands of people each year. TB also ranks as the sixth leading cause of death in the country. During this reporting year, NTP registered 34,121 TB cases.






Among them 15,655 (46%) were new smear 
positive TB cases, 2,202 (6%) were smear positive retreatment cases, 6,686 (20%) were sputum smear negative and 8,966 (26%) were extra‐pulmonary TB cases. Out of total registered cases in NTP, there were 12,300 (36%) female and 21,821 (64%) male. According to the latest WHO data published in May 2014, tuberculosis deaths in Nepal reached 5,506. This is 3.5% of total deaths. The age adjusted death rate is 27.80 per 100,000 of population. This ranks Nepal as 43 in the world. 

The majority of TB cases and deaths occur among men, the burden of disease among women seems significantly lower (2:1). TB mortality is unacceptably high given that most deaths are preventable if people can access tuberculosis care for diagnosis and the correct treatment is provided. Short‐course regimens of first‐line drugs that can cure around 90% of all cases (Treatment success rate reported in 2014/15) have been recorded for a decade. National Tuberculosis Program has adopted the global STOP TB Strategy and Million Development Goals (MDGs) as TB control strategy of the country Tuberculosis (TB), a major public health problem of Nepal infected About 45 percent of the total population. Every year, about 45,000 people develop active TB, out of them 20,000 have infectious pulmonary disease and that are able to spread the disease to others. Treatment by Directly Observed Treatment Short course (DOTS) has reduced the number of deaths. DOTS have successfully been implemented throughout the country since April 2001.



A total of 4244 DOTS treatment centers are providing TB treatment service. Expansion of this cost effective and highly successful treatment strategy has proven its efficacy in reducing the mortality and morbidity in Nepal. The NTP has coordinated with the public sectors, private sectors, local government bodies, I/NGOs, social workers, educational sectors and other sectors of society in order to sustain the present significant results achieved by National Tuberculosis Program (NTP).
Vision
Tuberculosis free Nepal
Goal
To reduce mortality, morbidity and transmission of tuberculosis until it is no longer a public health problem
Objectives:
  • To dramatically reduce the National burden of TB by 2015 in line with the Millennium Development Goals and the Stop TB Partnership targets
  • Achieve universal access to high‐quality diagnosis and patient‐centered treatment
  • Reduce the human suffering and socioeconomic burden associated with TB
  • Protect poor and vulnerable populations from TB, TB/HIV and multi‐drug‐resistant TB
Targets:
  • MDG 6, Target 8: ...halted by 2015 and begun to reverse the incidence.
  • Targets linked to the MDGs and endorsed by the Stop TB Partnership:
  1. By 2005: detect 100% of new sputum smear‐positive TB cases and cure at least 85%of these cases.
  2. By 2015: reduce prevalence of and death due to TB by 50% relative to 1990.
  3. By 2050: eliminate TB as a public health problem (<1 case per million population).
Components of the Stop TB strategy
1. Pursue high‐quality DOTS expansion &enhancement
  • Political commitment with increased and sustained financing
  • Case detection through quality‐assured bacteriology
  • Standardized treatment with supervision and patient support
  • An effective drug supply and management system
  • Monitoring and evaluation system, and impact measurement




2. Address TB/HIV, DR‐TB and other challenges
  • Implement collaborative TB/HIV activities
  • Prevent and control multi‐drug‐resistant TB
  • Address prisoners, refugees and other high‐risk groups and special situations
3. Contribute to health system strengthening
  • Actively participate in efforts to improve system‐wide policy, human resources, financing,management, service delivery, and information systems
  • Share innovations that strengthen systems, including the Practical Approach to Lung Health (PAL)
  • Adapt innovations from other fields
4. Engage all care providers
  • Public‐Public, and Public‐Private Mix (PPM) approaches
  • International Standards for Tuberculosis Care (ISTC)














5. Empower people with TB, and communities
  • Advocacy, communication and social mobilization
  • Community participation in TB care
  • Patients' Charter for Tuberculosis Care
6. Enable and promote research
  • Programme‐based operational research
DoHS, Annual Report 2071/72 (2014/2015)
END TB STRATEGY (WHO)

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