National Tuberculosis Programme Annual Report 2018
Tuberculosis (TB) remains a major public problem in Nepal. In 2017/18, the total of 32,474 cases of TB were notified and registered at NTP. Among these, 98% (31,723) were incident TB cases (New and Relapse). 71 % of among all TB cases were pulmonary TB, and out of them, 80% were bacteriologically confirmed. Among those bacteriologically confirmed, 30% (9,897) were confirmed using Xpert MTB/RIF testing. More than three-fifths of all TB cases (21,462, 66%) were reported from Province 2, Province 3 and Province 5. Province 3 holds the highest proportion of TB cases (24%). Kathmandu district alone holds around 41% (3,183 TB cases) of the TB cases notified from the province 3 while its contribution is around 10% in the national total. Whereas in terms of eco-terrain distribution, Terai belt reported more than half of cases (18,590, 57%). Most cases were reported in the productive age group (highest of 50 % in 15-44 year of age). The childhood TB is around 5.5% while men were nearly 1.73 times more than women among the reported TB case.
Among 32,474 cases notified during the year, 19% of cases were reported by the private sector and 20% by community referral.
Case notification rate (CNR) of all forms of TB is 112/100,000 whereas CNR for incident TB cases (new and relapse) is 109/100000 population. This year CNR of all forms of TB has increased by 1% compared to that of the previous year.
TB services were provided through 4,323 treatment centers, however, only 80% of these facilities had registered and managed 1 or more cases of TB this year. There are further 96 Urban DOT centers providing DOT services in the country. Regarding diagnostic services, there are 624 Microscopic centers and 55 Genexpert centers (with 58 Genexpert machines in total) in the country. DRTB services were provided through 21 treatment centers and 86 Treatment Sub-centers. Though the DRTB services are ambulatory, facility-based services were also provided through 2 referral centers located in Nepalgunj and Kalitmati Kathmandu, 6 hostels and 1 DR home for a patient with limited access to these centers for daily DOT or needing inpatient services. Culture and DST facilities for DRTB patients were provided from rational reference laboratories at NTC and GENETUP at the central level.
In 2017/18, USD 11.16 million budget was approved for the National TB Programme from the source of Domestic, Global Funds, & LHL International. Out of the total approved amounts 70.5% budget consumed by the programme.
Excerpt from Executive Summary