National Tuberculosis Control Programme

Dhaka, Bangladesh

National Tuberculosis Control Programme

Dhaka, Bangladesh
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Robert J.,University Pierre and Marie Curie | Affolabi D.,Programme National contre la Tuberculose | Awokou F.,National Tuberculosis Control Programme | Nolna D.,National Tuberculosis Control Programme | And 4 more authors.
Infection Control and Hospital Epidemiology | Year: 2013

background. The prevention of tuberculosis (TB) transmission in healthcare settings is a major issue, particularly because of the interaction between human immunodeficiency virus and TB and the emergence of multidrug-resistant TB. setting. Healthcare facilities involved in TB management in 4 African countries (Benin, Cameroon, Cote d'Ivoire, and Togo). methods. A questionnaire was developed by representatives of the 4 countries to evaluate the organizational measures implemented in facilities involved in TB management. On-site visits were performed between July 2010 and July 2011. results. A total of 115 facilities, including 10 university hospitals and 92 basic management units, were visited. None had a TB infection control plan, and only 5.2% provided education for staff about nosocomial TB. Overall, 48.3% of the facilities performed triage of suspected TB cases on hospital arrival or admission, 89.6% provided education for TB cases on cough etiquette, 20.0% segregated smear-positive TB cases, and 15.7% segregated previously treated cases. A total of 15.5% of the facilities registered TB among staff, for a global prevalence rate of 348 cases per 100,000 staff members. conclusion. This survey identified simple and mostly costless administrative measures to be urgently implemented at the local level to prevent nosocomial TB, such as staff education, triage on admission, and segregation of previously treated patients. © 2012 by The Society for Healthcare Epidemiology of America. All rights reserved.

PubMed | Foundation Medicine, University of Medical Sciences and Technology, National Tuberculosis Control Programme and Nile Valley University
Type: Evaluation Studies | Journal: Eastern Mediterranean health journal = La revue de sante de la Mediterranee orientale = al-Majallah al-sihhiyah li-sharq al-mutawassit | Year: 2016

Tuberculosis is a major health problem in Sudan, a country that carries 11-15% of the tuberculosis burden in the Eastern Mediterranean Region. This study aimed to describe the epidemiology of tuberculosis in River Nile State and to compare treatment outcomes with WHO recommended indicators. A descriptive study was conducted on data collected from records of 1221 patients registered at tuberculosis management units over the 3 years 2011-2013. The mean age of cases was 37.7 (SD 21.5) years and 65.9% were males; 76.3% were pulmonary tuberculosis and 36.9% were sputum smear-positive cases. Average values for all outcome indicators were suboptimal, notably rates of case notification (30.8 per 100 000), case detection (10.3%), treatment success (79.6%), treatment failure (3.0%), default (8.1%) and death (8.0%). Of the 264 patients tested for HIV, 3.8% were positive. Outcome indicators for the national tuberculosis control programme are lagging behind the required targets.

Zafar Ullah A.N.,University of Leeds | Huque R.,University of Dhaka | Husain A.,National Tuberculosis Control Programme | Akter S.,Society for Empowerment | And 2 more authors.
BMJ Open | Year: 2012

Objectives: In Bangladesh, private healthcare is common and popular, regardless of income or area of residence, making the private sector an important player in health service provision. Although the private sector offers a good range of health services, tuberculosis (TB) care in the private sector is poor. We conducted research in Dhaka, between 2004 and 2008, to develop and evaluate a public-private partnership (PPP) model to involve private medical practitioners (PMPs) within the National TB Control Programme (NTP)'s activities. Since 2008, this PPP model has been scaled up in two other big cities, Chittagong and Sylhet. This paper reports the results of this development, evaluation and scale-up. Design: Mixed method, observational study design. We used NTP service statistics to compare the TB control outcomes between intervention and control areas. To capture detailed insights of PMPs and TB managers about the process and outcomes of the study, we conducted in-depth interviews, focus group discussions and workshops. Setting: Urban setting, piloted in four areas in Dhaka city; later scaled up in other areas of Dhaka and in two major cities. Findings: The partnership with PMPs yielded significantly increased case finding of sputum smearpositive TB cases. Between 2004 and 2010, 703 participating PMPs referred 3959 sputum smear-positive TB cases to the designated Directly Observed Treatment, Short-course (DOTS) centres, contributing about 36% of all TB cases in the project areas. There was a steady increase in case notification rates in the project areas following implementation of the partnership. Conclusions: The PPP model was highly effective in improving access and quality of TB care in urban settings.

Zafar Ullah A.N.,University of Leeds | Huque R.,University of Dhaka | Husain A.,National Tuberculosis Control Programme | Akter S.,Society for Empowerment | And 2 more authors.
International Journal of Tuberculosis and Lung Disease | Year: 2012

OBJECTIVES: To implement and evaluate a public-private partnership model involving garment factories to reduce the tuberculosis (TB) burden in this workforce. DESIGN: We used operational research to develop and evaluate a mechanism for effective and sustainable TB control in workplaces in three areas of Dhaka, Bangladesh. Strategies, protocols, guides and tools were developed with stakeholders. We assessed the impact of the project using quantitative and qualitative measures: changes in TB outcomes were calculated using standard indicators based on factory and DOTS centre records; changes in TB care-seeking behaviour were assessed using qualitative in-depth interviews with factory managers and medical personnel, and focus group discussions with factory workers, including TB patients. FINDINGS: The project brought positive changes in knowledge, attitudes and practices of managers, workers and health care providers on TB care and control. During 2008-2010, a total of 3372 workers from a workforce of 69 000 were referred for sputum microscopy and 598 were diagnosed with smear-positive TB, 145 of whom received care at their workplace. The overall treatment success rate was 100%. CONCLUSION: It is feasible to engage factories in TB control activities in Bangladesh, and thereby increase case notifications and improve treatment outcomes. © 2012 The Union.

Sanchez-Padilla E.,Epicentre | Dlamini T.,National Tuberculosis Control Programme | Ascorra A.,Epicentre | Rusch-Gerdes S.,National Reference Center for Mycobacteria | And 6 more authors.
Emerging Infectious Diseases | Year: 2012

In Africa, although emergence of multidrug-resistant (MDR) tuberculosis (TB) represents a serious threat in countries severely affected by the HIV epidemic, most countries lack drug-resistant TB data. This finding was particularly true in the Kingdom of Swaziland, which has the world's highest HIV and TB prevalences. Therefore, we conducted a national survey in 2009-2010 to measure prevalence of drug-resistant TB. Of 988 patients screened, 420 new case-patients and 420 previously treated casepatients met the study criteria. Among culture-positive patients, 15.3% new case-patients and 49.5% previously treated case-patients harbored drug-resistant strains. MDR TB prevalence was 7.7% and 33.8% among new casepatients and previously treated case-patients, respectively. HIV infection and past TB treatment were independently associated with MDR TB. The findings assert the need for wide-scale intervention in resource-limited contexts such as Swaziland, where diagnostic and treatment facilities and health personnel are lacking.

Bassili A.,World Health Organization | Al-Hammadi A.,National Tuberculosis Control Programme | Al-Absi A.,National Tuberculosis Control Programme | Glaziou P.,World Health Organization | And 4 more authors.
International Journal of Tuberculosis and Lung Disease | Year: 2013

BACKGROUND: The lack of applicable populationbased methods to measure tuberculosis (TB) incidence rates directly at country level emphasises the global need to generate robust TB surveillance data to ascertain trends in disease burden and to assess the performance of TB control programmes in the context of the United Nations Millenium Development Goals and World Health Organization targets for TB control. OBJECTIVE: To estimate the incidence of TB cases (all forms) and sputum smear-positive disease, and the level of under-reporting of TB in Yemen in 2010. METHODS: Record-linkage and three-source capturerecapture analysis of data collected through active prospective longitudinal surveillance within the public and private non-National Tuberculosis Programme sector in twelve Yemeni governorates, selected by stratified cluster random sampling. RESULTS: For all TB cases, the estimated ratio of notified to incident cases and completeness of case ascertainment after record linkage, i.e., the ratio of detected to incident cases, was respectively 71% (95%CI 64 -80) and 75% (95%CI 68-85). For sputum smear-positive TB cases, these ratios were respectively 67% (95%CI 58- 75) and 76% (95%CI 66-84). CONCLUSION: We estimate that there were 13 082 (95%CI 11 610-14 513) TB cases in Yemen in 2010. Under-reporting of TB in Yemen is estimated at 29% (95%CI 20-36). © 2013 The Union.

Huseynova S.,World Health Organization | Hashim D.S.,National Tuberculosis Control Programme | Tbena M.R.,National Tuberculosis Control Programme | Harris R.,Public Health England | And 5 more authors.
International Journal of Tuberculosis and Lung Disease | Year: 2013

BACKGROUND: The global target for tuberculosis (TB) control set by the Millennium Development Goals is a decrease in TB incidence by 2015. Direct measurement of country-level TB incidence using population-based methods is impractical, emphasising the need for wellperforming surveillance systems and, where these are not available, accurate quantification of incidence and under-reporting of TB. OBJECTIVE: To estimate TB incidence and TB underreporting in Iraq in 2011. METHODS: Prospective longitudinal surveillance was established among all eligible public and private non- National TB Programme (NTP) providers in a random sample of eight of the 18 Iraqi governorates from May to July 2011. Record linkage with the NTP and threesource capture-recapture analysis of data were then conducted using log-linear modelling. RESULTS: A total of 1985 TB cases were identified after record linkage. The NTP registered 1677 patients (observed completeness 84%). The estimated total number of TB cases was 2460 (95%CI 2381-2553), with identified TB cases representing 81% (95%CI 69-89) after adjusting for sampling design. The estimated ratio of notified to incident cases was 69% (95%CI 58-76). CONCLUSIONS: We estimate 14 500 TB cases in Iraq in 2011, of which 31% (95%CI 24-42) were unreported. TB surveillance needs to be strengthened to reduce under-reporting. © 2013 The Union.

Kuaban C.,University of Yaounde I | Kuaban C.,University of Bamenda | Noeske J.,Yaounde | Rieder H.L.,International Union Against Tuberculosis and Lung Disease | And 4 more authors.
International Journal of Tuberculosis and Lung Disease | Year: 2015

SETTING: Two specialised multidrug-resistant tuberculosis (MDR-TB) treatment units in Cameroon. OBJECTIVE: To assess outcome and adverse drug events with a standardised 12-month regimen for MDR-TB among second-line drug naïve patients. DESIGN: Prospective observational study of MDR-TB patients treated with a standardised 12-month regimen including gatifloxacin, clofazimine, prothionamide, ethambutol and pyrazinamide throughout, supplemented by kanamycin and isoniazid during an intensive phase of a minimum of 4 months. Progress was monitored monthly until treatment completion and twice over one year after treatment cessation. RESULTS: Eighty-seven potentially eligible patients were lost and never treated due to delayed availability of test results. Among the 150/236 eligible and treated patients, 134 (89%) successfully completed treatment, 10 died, 5 were lost, 1 failed and none relapsed. The patients' mean age was 33.7 years (range 17-68), 73 (49%) were females, 120 (80%) had failed on previous treatment, 30 (20%) were human immunodeficiency virus seropositive, 62 (43%) had a body mass index <18.5 kg/m2 and 41 (27%) had radiographic involvement of five or six of the six lung zones. The most important adverse drug event was hearing impairment, which occurred in 46 of 106 (43%) patients. CONCLUSIONS: These results add further evidence for the usefulness of shorter, standardised regimens among patients without second-line drug resistance. © 2015 The Union.

Ali A.,Aga Khan University | Hasan R.,Aga Khan University | Jabeen K.,Aga Khan University | Jabeen N.,Aga Khan University | And 2 more authors.
Antimicrobial Agents and Chemotherapy | Year: 2011

The increasing incidence of extensively drug-resistant (XDR) Mycobacterium tuberculosis in high-tuberculosis- burden countries further highlights the need for improved rapid diagnostic assays. An increasing incidence of XDR M. tuberculosis strains in Pakistan has been reported, but drug resistance-associated mutations in these strains have not been evaluated previously. We sequenced the "hot-spot" regions of rpoB, katG, inhA, ahpC, gyrA, gyrB, and rrs genes in 50 XDR M. tuberculosis strains. It was observed that 2% of rifampin, 6% of isoniazid, 24% of fluoroquinolone, and 32% of aminoglycoside/capreomycin resistance in XDR M. tuberculosis strains would be undetected if only these common hot-spot regions were tested. The frequencies of resistance-conferring mutations were found to be comparable among all XDR M. tuberculosis strain families present, including the Central Asian Strain, Beijing, and East African Indian genogroups and the Unique isolates. Additional genetic loci need to be tested for detection of mutations conferring fluoroquinolone, aminoglycoside, and capreomycin resistance in order to improve molecular diagnosis of regional XDR M. tuberculosis strains. Copyright © 2011, American Society for Microbiology. All Rights Reserved.

Metzger P.,World Health Organization | Baloch N.A.,National Tuberculosis Control Programme | Kazi G.N.,World Health Organization | Bile K.M.,World Health Organization
Eastern Mediterranean Health Journal | Year: 2010

Pakistan has shown drastic expansion of tuberculosis (TB) care during the past 10 years, increasing case notifications from 11 050 in 2000 to 248 115 in 2008. Over 1 million TB patients have been cared for since 2000, with a treatment success rate of 91% in 2007. This paper examines the strategic decisions and infrastructure improvements underlying this achievement, such as the implementation of universal DOTS coverage, expansion of the laboratory network, effective drug management systems, improved communication strategies, and inclusion of private practitioners, laboratories and hospitals in the TB control programme through the publicprivate mix strategy. The paper also outlines challenges faced in further expanding TB control within the private sector and parastatal health care institutions; strengthening the laboratory network for diagnosis of drug-resistant TB; and ensuring uninterrupted supply of quality anti-TB drugs, all requiring continued and coordinated technical and donor support.

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