Tuberculosis
(TB) is a major public health problem in Bangladesh
since long. Estimates suggest that daily about 880 new
TB cases and 176 TB deaths occur in the country. About
391/100 000 population are suffering from active disease
(all type).
In 1965, tuberculosis services were mainly curative
and based in TB clinics and TB hospitals. After long
time TB services were expanded to 124 upazila
health complexes (UHCs) during the Second Health and
Population Plan (1980-86), and were operationally integrated
with leprosy during the Third Health and Population
Plan (1986-91) under the Mycobacterial Disease Control
(MBDC) unit of the Directorate-General of Health Services
(DGHS).
The program augmented adopting the DOTS strategy during
the Fourth Population and Health Plan (1992-98) under
the project “Further Development of TB and Leprosy
Control Services”. The program was known as NTP
(National Tuberculosis Control Program) and started
its field implementation in November 1993 in four upazilas,
sub-district. It was progressively expanded
to cover all upazilas by mid-1998. In July
1998, the NTP was integrated into the Communicable Disease
Control component of the Essential Services Package
under the Health and Population Sector Program (HPSP-1998-2003).
In 2003, HPSP was renamed as “Health, Nutrition
and Population Sector Program” (HNPSP) and NTP
is recognized as a priority health program in HNPSP.
In
2002, DOTS was expanded to Dhaka Metropolitan City and
other urban areas. At present the country’s DOTS
coverage is geo-administratively 100%. Free-of-charge
diagnostic and treatment services for TB are now available
in all upazila health complexes, chest disease
clinics, urban clinics, chest disease hospitals, public
and private medical colleges, district sadar hospitals,
defense hospitals, prisons and workplaces.
The program is maintaining high treatment success rates
from the beginning and met the target of 85% treatment
success since 2003. The program has successfully treated
over 92% of the new smear-positive cases registered
in 2006 and has detected over 72% of the estimated new
smear-positive cases in 2007. The partnership between
government and NGOs was instrumental for such achievement.
The Government of Bangladesh, together with its many
and diverse partners from the public and private sectors,
is committed to further intensify the DOTS program in
order to sustain the achieved success and to reach the
TB control targets linked to the Millennium Development
Goals (MDGs) in the present HNPSP.
The vision of the programme is tuberculosis is eliminated
in Bangladesh (i.e. incidence of TB disease is less
than one new case per million populations per year).
The mission of the programme is that the NTP aims to
strengthen the effort of TB control through effective
partnerships, mobilization of resources and ensuring
quality diagnostic and treatment services under defined
DOTS strategy. The NTP strives to make services equally
available to all people in Bangladesh irrespective of
age, sex, religion, ethnicity, social status or race.
The overall goal of TB control is to reduce morbidity,
mortality and transmission of TB until it is no longer
a public health problem.
The objectives of NTP are:
in order to then
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