National Tuberculosis Control Program

Tuberculosis (TB) is a major public health problem in Bangladesh since long. Estimates suggest that daily approximately 875 new TB cases and 180 TB deaths occur in the country.

In 1965, tuberculosis services were mainly curative and based in TB clinics and TB hospitals. 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) Diractorate of the Directorate-General of Health Services (DGHS).

The revised NTP adopted the DOTS strategy during the Fourth Population and Health Plan (1992-98) under the project “Further Development of TB and Leprosy Control Services”. The NTP started its field implementation in November 1993 in four thanas (upazilas) of 2 districts and 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). In 2003, HPSP was renamed “Health, Nutrition and Population Sector Program” (HNPSP) and NTP is recognized as one of the priority program in HNPSP.

In 2002, DOTS was expanded to Dhaka Metropolitan City and by 2003, 99% of the country’s population was brought under DOTS services.

The quality of NTP continues to improve. 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 92% of the new smear-positive cases registered in 2006 and has detected 72% of the estimated new smear-positive cases in 2007.

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).

The Bangladesh NTP has published quarterly and annual reports since 2002. These reports highlighted the main activities related to TB control and describe the achievements in case detection and treatment success with special attention to infectious (i.e. new smear-positive) cases. This report covers the activities related to TB control performed in 2006, case finding in 2006 and treatment outcomes of cases registered in 2005. The country’s population for 2006 was calculated based on the most recent report of the Bangladesh Bureau of Statistics. The annual incidence for new smear-positive cases was estimated 102 per 100 000 population. Cases detected in CDCs and metropolitan areas have been included besides the notifications from upazilas. The results are organized in three levels: national, divisional and district. This time the document has been titled as “Tuberculosis Control in Bangladesh –Annual Report 2007 (instead of 2006) according to the publication year. 

Vision Statement of the National TB Control Program

The vision of the NTP is to eliminate TB as a Public Health Problem from Bangladesh (i.e. incidence of TB disease is less than one new case per million population per year).

Mission Statement of the National TB Control Program

National Tuberculosis Control Program (NTP) aims to strengthen the effort of TB Control through effective partnership, mobilizing resources and ensuring quality diagnostic and treatment services under defined Directly Observed Treatment Short Course (DOTS) strategy. The service should be equally available to all people of Bangladesh irrespective of age, sex, religion, ethnicity, social status and race.

Goal of Tuberculosis Control

The overall goal of TB control is to reduce morbidity, mortality and transmission of TB until it is no longer a public health problem.

Objectives of the National Tuberculosis Control Program

The objectives of NTP are:

To reach and thereafter sustain the global targets of achieving at least 70% case detection and 85% treatment success among smear-positive TB cases under DOTS;

in order to then

Reach the interim target of halving the TB death rate and TB prevalence by 2010 towards achieving a reduction of incidence of TB, as stated under the MDGs (2015).

SERVICES OF THE PROGRAM

The NTP follows the DOTS strategy to improve the quality of the TB services. Implementation of the strategy started in November 1993 in four upazilas in two districts. By 2003, the program had been established in all upazilas, 44 chest disease clinics (CDCs) and 6 metropolitan cities in collaboration with nongovernmental organizations (NGOs).

Free-of-charge diagnostic and treatment services for TB are offered under NTP in the following places:

• all UHCs

• 44 CDCs

• 8 Chest Disease Hospitals linked to the CDCs

• 4 Divisional Chest Disease Hospitals the National Institute of Diseases of Chest and Hospital (NIDCH), Dhaka

• the Government Leprosy Hospital in Nilphamari

• urban health centres in Barisal, Chittagong, Dhaka, Khulna, Rajshahi and Sylhet metropolitan cities (GoB and NGOs)

• public and private medical college hospitals

• work places

• prisons

• Combined Military Hospitals and other defense hospitals run by Bangladesh Rifles, Bangladesh Police and Bangladesh Ansar

• District Sadar Hospitals