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Goals and
objectives
of the National TB Control Programme (
NTP)
The overall goal of the
NTP is to reduce morbidity, mortality and transmission of TB until the
disease is no longer a public health problem.
The objectives are to detect 70% of new
smear-positive pulmonary TB cases and cure at least 85 % of them by the year
2005 and be maintained thereafter to reach the MDG by 2015.
DOTS
strategy
List of DOTS
Centres
The NTP adopted the WHO recommended
strategy of Directly Observed Treatment Short-course (DOTS) in 1993.The DOTS
strategy consists of five components:
- Political commitment
- Diagnosis by direct microscopy
- Directly Observed Treatment (DOT)
- Uninterrupted supply of drugs
- Standard recording and monitoring of
detection
and treatment results
Achievements
Since the introduction of
DOTS
the NTP and its partners have achieved
satisfactory
treatment results in new smear-positive
patients,
84% treatment success among the patients
detected
during 2001. However, case detection has
remained
under 35%. During 2004 the detection rate
of new smear-positive patients was 46%.During 2005 the detection rate of new
smear-positive patients was 61% and treatment
success rate 89%.
Recent
developments
1.
Treatment
- Change in regimen for new
smear-positive
and for smear-negative and
extra-pulmonary
patients, as follows:
- regimen for new smear-positive
patients
and other severely ill patients:
2HRZE/4H3R3
- regimen for relapses and failures :
2SHRZE/1REHZ/5R3E3H3
- regimen for smear-negative and
extra-pulmonary
patients: 2HRZ/4H3R3
- Change in formula of the drugs, from
loose
drugs to fixed dose combinations (FDC's)
of
4 drugs (smear-positive patients), 3
drugs
(smear-negative and extra-pulmonary
patients)
and 2FD's (all patients during the
continuation
phase of the treatment).
- Provision of FDC's in blister packs.
After
diagnosis the full treatment of the
patient
will be set aside.
2. Continuation of a pilot project on public-private
partnership, involving 63 chest physicians and general practitioners in
Dhaka City.
3. Public Private Partnership Project, an
operational research project collaborated between NTP and Nuffield
Institute for Health, University of LEEDS, UK started its activities in
March, 2004. This project is aimed to develop an innovative partnership
model for effective involvement of private practitioners in service delivery
of the TB control activities in Bangladesh.
4. DOTS expansion in Dhaka and other metropolitan
cities. After detailed preparation and training of staff, the number of
diagnostic and treatment facilities in Dhaka and other city corporations has
been increased.
5. Opening of new DOTS corners in medical
colleges
6. Opening DOTS Centers at work places.
7. Expansion of DOTS in prisons.
Major challenges to reaching the case
detection target
Major challenges include
increasing and maintaining high levels of commitment at policy levels,
improving the quality of the diagnostic services, intensifying partnership
with NGO's, the private sector, academic institutes and workplaces,
strengthening, monitoring and evaluation and implementation of HRD TB
Control.
Important
events( From January to March,2006):
-
Dr Mamel Quelapio (Tempo Adviser/STC for HQ)
& Eva Nathanson- visited NTP for preparation of proposal to GLC
(supported by NTP, Microbiologist and
Clinician from NIDCH) also preparation of
DOTS-Plus Guideline (supported by NTP,
Microbiologist and Clinician from NIDCH)
-
Mr Somsak Rienthong, Chief of
NTRL,
Bangkok
visited
NTP
Bangladesh
to assist NTP- to monitor on-going activities
of National Reference Laboratory (NRL) at
NIDCH, planning of HRD for Laboratory
services and to monitoring existing EQA
system and recommend measure for its
strengthening.
-
Ms. Fujiki of RIT, Japan (JICA Short term expert on
Laboratory Management) visited NTP
Bangladesh to conduct the orientation and
the refresher training on EQA, to make
observation visit to EQA centers, diagnostic
centers to collect information on EQA
activities for AFB microscopy and to discuss
future technical assistance on TB Lab
services on NTP.
-
Ms Christa Arent of GFATM
to evaluate 2nd phase Round 3 and
to review GFATM Round 5, 1st
Phase for signature of PRs.
-
Mr Mehran and Mr Danial Bleed of WHO
H/Q visited
Bangladesh
to work
on the
Bangladesh
chapter
of Global database system of TB as well as
to share the Global database system (STAR
project)
Training and Workshops (From January to March, 2006):
National:
- Management Course on TB- for
Barisal
Division
held at CS Office,
Barisal
. This
course is designed for UH&FPOs & MOs of
Barisal
district, Barisal Medical College &
Hospital, Barisal City Corporation and BRAC.
Total Thirty Two participants attended at the course.
- Quarterly Monitoring Meeting( ) - for UH&FPO, MO, LTCA, Pharmacist,
Medical Technologist (Lab) of
Dhaka
Division- Sherpur, Jamalpur, Mymensingh, Netrokona, Kishoreganj, Narshingdi.
- Quarterly Monitoring Meeting - for UH&FPO, MO, LTCA, Pharmacist,
Medical Technologist (Lab) of Rajshahi
Division- Rajshahi, Chapai, Naogaon, Natore,
Pabna, Sirajgonj.
- Quarterly Monitoring Meeting - for UH&FPO, MO, LTCA, Pharmacist,
Medical Technologist (Lab) of
Barisal
Division- Barisal, Pirojpur, Jhalokhati,
Bhola, Patuakhali, Borguna.
- Quarterly Monitoring Meeting - for UH&FPO, MO, LTCA, Pharmacist,
Medical Technologist (Lab) of
Khulna
Division- Khulna, Bagerhat, Satkhira,
Jessore, Narail, Jhenaidaha.
- Quarterly Monitoring Meeting - for UH&FPO, MO, LTCA, Pharmacist,
Medical Technologist (Lab) of
Chittagong
Division-
Khagrachari, Rangamati, Bandarban, Cox’s
Bazar, Noakhali, Feni.
- Field Level Training- for
Khulna
Division
(11 Districts), Rajshahi Division (16
Districts.)
-
Advocacy Workshop on DOTS in Medical Colleges- for GP,
Doctors, and Senior staff nurses of the
General
Hospital
, Tangail.
Total 160 participants attended at the
course.
-
Management Course on TB-
for
Rajshahi Division held at CS Office,
Kurigram. This course is designed for UH&FPOs & MOs of
Kurigram & Gaibandha and BRAC & RDRS.
Total thirty seven participants attended at
the course.
-
Management Course on TB-
for
Chittagong
Division
held at CS Office, Comilla. This course is
designed for UH&FPOs & MOs of
Comilla & B. Baria and BRAC. Total
Thirty Five participants at attended the
course.
Management
Course on TB-
for Defense/Private Hospital
-
Management Course on TB-
At Cox’s Bazar for UNHCR
-
Quarterly Monitoring meeting-
for UH&FPO,
MO, LTCA, Pharmacist, Medical Technologist
(Lab) of
Dhaka
Division (Rajbari, Faridpur, Madaripur, Gopalganj,
Shariatpur districts
-
Quarterly Monitoring meeting-
for UH&FPO,
MO, LTCA, Pharmacist, Medical Technologist
(Lab) of Rajshahi Division (Lalmonirhat,
Nilphamari, Dinajpur, Thakurgaon, Panchagar districts).
-
Advocacy Workshop on DOTS in Medical Colleges-
Community Hospital, Gonoshastho etc
-
Planning Workshop with NTP Partners
International(From January to March, 2006):
· International
Course in Management, Finance and Logistics for
TB Control,
Jaipur
,
India-
2 GoB
officials participated at the course.
Printing
and Publications
(From January to March 2006)
· Fact
sheet on Tuberculosis on the eve of World TB
Day-2006
Important events (Till December, 2005)
- NTP initiated dissemination of TB information
since February 2005 through cable TV network at urban and peri-urban
areas of
Dhaka
city. The information is being displayed by courtesy of
United Commercial Services( UCS) and Dhaka City Corporation Network
(DCCN).
- Ms. Ineke
Petter, Consultant, HRD visited
Bangladesh
from 10 to
17 February, 2005
to assess HR
capacity, assist to review existing
curriculum and provide technical guidance in
updating different training curriculums.
During her visit she also assisted NTP in
developing tools for monitoring and
training.
- Ms Eva,
Consultant, DOTS-plus, Geneva, WHO visited
Bangladesh from 12 to 17 February, 2005 to prepare plan for
Drug Resistance Surveillance (DRS) .She also
assisted NTP to explore the scope of
DOTS-plus in Bangladesh.She visited
NIDCH, National Reference Laboratory,
Shaymoli and Mirzapur clinic (Damien
Foundation) for conducting need assessments
for DRS and piloting and expanding MDR-TB
management under NTP.
- NTP and
BRAC participated at cricket carnival from 19th
to 23rd February organized
by Bangladesh Cricket Board to disseminate TB
messages through display of banner at
play ground and distribution of printed materials to the audiences.
- Bangladesh
Scouts participated at 11th Rover Scout Moot from
25th February to
1st March, 2005
and actively
participated to disseminate TB messages.
More than 1000 rover scouts and leader from
different colleges and universities all over
Dhaka
district participated at the scout camp. They worked at 3 villages
to disseminate TB related information
through distribution of poster/stickers and
interpersonal communication.
- Ms. Angela
Smith, Fund Portfolio Manager, The Global
Fund to Fight AIDS, TB and Malaria(GFATM),
Geneva
visited
Bangladesh
from 28th February to
7th March, 2005
to discuss
implementation status of GFATM activities
in
Bangladesh
. She discussed different financial and programmatic issues with MOH&W,
WHO, NTP and its partners.
- NTP
organized a Strategic Planning workshop from
13th to 15th March at
Training and Resources Center of BRAC at
Savar. The objective of the workshop was to
develop a draft strategic plan for 2006 to
2010. NTP and its partner NGOs(BRAC, NSDP,
UPHCP, NATAB, Damien Foundation, ICDDR,B)
and WHO attended at the workshop.
- Mr. Gani
Perla, PPM DOTS Consultant, visited
Bangladesh
from 20th March to
2nd April, 2005
to assist NTP to review current PPM activities, assess
progress and provide technical guidance for
Public-Private partnership initiatives
for National TB control Program in
Bangladesh
.
- World Stop Day-2005 was celebrated on 24th March in a
befitting manner in
Bangladesh
. The slogan for World Stop TB Day-2005 for
Bangladesh
was ‘Stop TB-Ensure your participation. As a part of activities of
World TB Day, conference, rally and discussion
at national, divisional and district level were organized
jointly by WHO,NTP and partner NGOs.
- Mr Taufiqur Rahman, Team Leader, South and
West Asia
, The
Global Fund to Fight AIDS, TB and
Malaria(GFATM),
Geneva
visited
Bangladesh
from
May 8th to
15th , 2005
to
discuss implementation status of GFATM
activities in
Bangladesh
. He also discussed different financial and programmatic issues with
MOH&W, WHO, NTP and its partners.
- Dr. Armand Van Deun, MD, Bacteriology Consultant for The Union
Mycobacteriology Unit, Institute of Tropical
Medicine and Dr Somsak Rienthong, Senior
Medical Scientist and chief of National TB
Reference Laboratory Centre (NTRLC) visited
Bangladesh from 12th to 25th June, 2005 to provide technical
support on (a) External quality assurance (b)
New settings for National Reference
Laboratory(NRL) (c) Linkage of
National Reference Laboratory with other
laboratory net works (d) Guidelines for
NRL
- Dr. Peter Helbling and Dr. Christine Whalen of GDF visited
Bangladesh from 22nd to
26th August-2005 to assess
adherence to GDF terms and conditions of
support, program management (including case
finding and treatment outcomes), financial
and drug management, drug needs for next
year of GDF support and issues raised by the
GDF Technical Review Committee (TRC)
- Ms. Christa Arent, Fund Portfolio Manager and Mr. Taufiqur Rahman,
Team Leader, South and
West Asia
, The Global Fund to Fight AIDS, TB and
Malaria(GFATM),
Geneva
visited
Bangladesh
from 6th to
14th October,
2005
to discuss
implementation status of GFATM activities
in
Bangladesh
. They also discussed different financial and programmatic issues
with MOH&W, WHO, NTP and its partners
- Quarterly Monitoring Meeting ( From
July 16th to 19th, 2005
) for UH&FPO, MO, LTCA, Pharmacist, Medical Technologist (Lab)
of Sylhet Division.
- Quarterly Monitoring Meeting ( August 20- Sepmber 06,
2005) for UH&FPO, MO, LTCA,
Pharmacist, Medical Technologist (Lab) of
Dhaka
Division.
- Quarterly Monitoring Meeting (September 17 –
October 06, 2005
) for UH&FPO, MO, LTCA, Pharmacist, Medical Technologist (Lab)
of
Dhaka
Division.
- NTP-NGO Partners meeting (
Oct. 30, 2005
) held at
NTP H/Q to review the progress of GFATM 3rd
round activities
and discussion on the future course of
Action.
Training
and Workshops (Till
December, 2005)
1. International
- Workshop on GFATM, a strategic approach to TB proposal in round 5,
21-25 February, 2005
- Annual Meeting of the National TB Control Program Managers of the
SEA region and meeting of the Technical
Working Group, 9-11 February, 2005, WHO- SEARO, New
Delhi
- International
Course in
Management, Finance and Logistics for TB
Control,
Jaipur
,
India
, 6-21 February, 2005.
- Third Meeting of Public Private Mix Subgroups for DOTS expansion,
Manila
,
Philippines
, 4-6 April, 2005.
- Consultant’s Workshop for Integration of Advocacy, Communication
and Social Mobilization in Global Fund
proposal,
Egypt
,
Cairo
, 2-9 April, 2005.
- 23rd International Conference on Tuberculosis and Lung
Diseases Eastern Region- (IUATLD-ER) in
Lahore, Pakistan under the auspices of
IUATLD in collaboration of National TB
Control Program, Government of Pakistan and
Pakistan Chest Society, September 25th
to 28th , 2005
- DOTS Expansion Working Group meeting and
the 36th Union World Conference on Lung
Health,
France
,
October 15th
to 22nd, 2005
- Program
Manager's Meeting at Nepal (Dec.04 -10)
2.
National
- Management Courses On Tuberculosis(16th to 21st
April, 2005)-Twenty six
participants attended.
- Management Courses On Tuberculosis(23rd to 28th
April 2005): Twenty five
participants attended .
- Training on
AFB
microscopy for Medical Technologist( January
to April): Total 19 courses were organized
and 228 medical technologists attended.
- Management Course on Tuberculosis (July 2-7) for Khulna Division
& Barisal Division held an NTP H/Q. Total thirty (Khulna-19,
Barisal-11) participants attended at the
course.
- Management Course on Tuberculosis(July 23rd to 28th,
2005) for Dhaka Division held at NTP
H/Q. Total Twenty eight participants from
GoB & NGOs (UPHCP & NSDP) attended
at the course
- Orientation on DOTS(
July 20, 2005
) for tea garden service providers in Sylhet for Medical Officers
& Paramedics.
- Laboratory Course (Basic) (July 2–7)for Medical Technologist (Lab)
held at TB Control and Training Institute,
Chankharpul,
Dhaka
.
- Laboratory Course (Basic) (
July 9–14, 2005
) for Medical Technologist (Lab) held at TB Control and Training
Institute, Chankharpul,
Dhaka
.
- Laboratory Course
(EQA)(
June 16 – 28, 2005
) for Medical Technologist (Lab) and Lab Supervisors held at CDC,
Shaymoli,
Dhaka
.
- Laboratory Course (EQA) (July 10 – 14) for Medical Technologist
(Lab) and Lab Supervisors held at CDC,
Shaymoli,
Dhaka
.
- Orientation on DOTS for General Practitioners (GPs)( July 08-2005)
held at NTP H/Q.
- Management Course on TB(August 13th to 18th
-2005)
for Khulna City Corporation and Khulna Jail
working on TB. Total Thirty participants
attended at the course
- Management Course on TB(August 20th to 25th
-2005) for
Khulna
Division. This course was designed for UH&FPOs & MOs of
Jessore & Khulna District. Total Thirty
Six participants from GoB & NGO
(Salvation Army) working on TB attended at
the course.
- Management Course on TB ( From 13th to 18t
August-2005) for Rajshahi Division. This course
was designed for UH&FPOs & MOs of
Rajshahi & Chapai Nowabganj District.
Total twenty nine participants from GoB
& NGOs working on TB attended at the course.
- Management Course on TB(
Aug. 20 – 25, 2005
) for Rajshahi Division. This course was designed for UH&FPOs
& MOs of Natore & Noagaon District.
Total Thirty Four participants attended at
the course
- Management Course on TB(
Aug. 20 – 25, 2005
) for Sylhet Division
held at Moulovibazar CS Office. This course
was designed for UH&FPOs & MOs of
Moulovibazar & Hobiganj District and
HEED. Total Thirty One participants attended
at the course.
- Management Course on TB(
Aug. 20 – 25, 2005
) on TB for Dhaka
Division held at NTP H/Q. This course was designed
for UH&FPOs & MOs of
Dhaka
, Gazipur &
Narayanganj District. Total Thirty Four
participants attended
at the course.
- Management Course on TB
(August 27
–
September 01,
2005
) for Chittagong
Division held at Chittagong CS Office. This
course was designed for UH&FPOs &
MOs of Chittagong District and BRAC/Ashar
Alo. Total thirty two participants from GoB & NGOs working on TB
attended at the course.
- Orientation on DOTS(
August 05, 2005
) for GPs
of PPPPP( Public-Private Partnership Pilot
Project) & respective NGOs held at NTP
H/Q.
- Orientation on DOTS for GPs(
August 15th 2005
) of Khulna City Corporation held at Khulna C/S Office,
Khulna
- Orientation on DOTS for GPs (31st August-2005)
of Chittagong City Corporation held at
C/S Office,
Chittagong
- Laboratory Course (Basic)( Aug. 13 – 18, 2005)
for GoB/NGO designated Laboratory Technicians held at TB
Control and Training Institute, Chankharpool
& Shyamoli.
- Laboratory Course (Basic) (Aug. 20 – 25, 2005)for GoB/NGO
designated Laboratory Technicians held in TB
Control and Training Institute, Chankharpool
& Shyamoli.
- Laboratory Course (Basic) (Aug. 27 – Sep. 01, 2005)for GoB/NGO
designated Laboratory Technicians held in TB
Control and Training Institute, Chankharpool
& Shyamoli.
- Workshop on Quality Care, Supervision and
Monitoring on DOTS(1st batch-
September 03 to 05, 2005
and 2nd batch-September 06th to 08th, 2005
) held at BRAC Centre,
Dhaka
- Workshop on Quality Care, Supervision and
Monitoring on DOTS (
Sept. 17 – 19, 2005
) held at
Khulna
- Management Course on TB(
September 10th to 15th , 2005
) for Rajshahi Division
held at
Pabna
Sadar
Hospital
, Pabna. Course was designed for UH&FPOs & MOs of Sirajganj,
Pabna Districts and LEPRA. Total Thirty
Eight participants working on TB attended at
the course from GoB & NGOs .
- Management Course on TB (
September 10th to 15th , 2005
) for Dhaka Division held at NTP H/Q. Course was designed for
UH&FPOs & MOs of Munshiganj,
Narayanganj & Norshingdi Districts and
Gono Shastha Kendra. Total thirty six
participants attended at the course from GoB
& NGOs working on TB.
- Management Course on TB (
September 10th to 15th , 2005
) for Khulna Division
held at School Health Clinic,
Khulna
. Course
was designed for UH&FPOs & MOs of
Satkhira & Bagherhat Districts and BRAC.
Total thirty four participants attended at
the course from GoB & NGOs working
on TB.
- Advocacy Workshop(
Sept. 01 – 02, 2005
) on DOTS at
Bajitpur
Medical
College
- Advocacy Workshop(
Sept. 22, 2005
) on DOTS at
BIRDEM
Hospital
- Management Course on TB (October 01- 06, 2005)
for Rajshahi Division held at Rangpur C/S
Office. This course was designed for UH&FPOs
& MOs of Ranpur & Lalmonirhat
Districts, BRAC and RDRS. Total thirty two participants
from GoB & NGOs working on TB attended
at the course.
- Management Course on TB (October 01- 06, 2005) for Rajshahi Division held at Bogra
C/S Office. Course was designed for UH&FPOs
& MOs of Bogra & Joypurhat Districts
and BRAC. Total Thirty Eight participants
attended at the course from GoB & NGOs
working on TB.
- Management Course on TB (Oct. 01 – 06) for Rajshahi Division held at Feni C/S
Office. Course was designed for UH&FPOs
& MOs of Feni, Noakhali & Laxmipur
Districts and BRAC. Total thirty five
participants from GoB & NGOs
working on TB attended at the course.
- Mid Level Training
(Oct. 25 – 31) for LTCA,
PO
, MA, held at respective District H/Q
- Advocacy Workshop on
DOTS (
Oct. 05 – 06, 2005
) at
Rangpur
Medical
College
- Orientation on DOTS for GPs (
Oct. 05, 2005
) of
Rangpur
Municipality
held at C/S Office, Rangpur
- Workshop on Quality Care, Supervision and
Monitoring on DOTS (Nov. 13 -15)- for Rajshahi Division held at BRAC INN,
Dhaka.
- NTP Coordination Meeting With Partners
held at NTO HQ, Dhaka (Nov. 17)
- Orientation on DOTS for GPs of Sylhet,
Jessore & Cox's Bazar (Nov. 26)
- Advocacy Workshop on DOTS in Ragib-Rabeya Medical College and
North-East Medical College, Sylhet (Nov. 27
-28)
- Management
Course on TB - for Khulna Division held at
BMA BHABAN, Jessore (Nov. 26 - Dec. 01)
- Management
Course on TB- for Sylhet Division held at CS Office,
Sylhet (Nov.26 - Dec.01)
- Management
Course on TB-for Rajshahi Division held at CS Office,
Dinajpur (Nov.26 - Dec.01)
- Management
Course on TB-for
Sylhet Division held at CS Office, Sylhet
(Dec.03 - 8)
- Management
Course on TB-for Chittagong Division held at CS Office,
Cox’s Bazar(Dec.03 - 08)
- Management
Course on TB-for Dhaka Division held at CS Office,
Mymensingh (Dec.03 - 08)
- Management
Course on TB-for Khulna Division held at BMA BHABAN,
Jessore (Dec.03
- 08)
- Management
Course on TB-for UH&FPOs & MOs of Nilphamari,
Panchagar, Thakurgaon districts held at CS
Office, Thakurgaon (Dec.03 - 08)
- Management
Course on TB-for Dhaka Division held at CS Office,
Mymensing (Dec.03 - 15)
- Management
Course on TB-for Dhaka City Corporation (Dec.03 - 15)
Printing
and Publications
- Revision
of laboratory manual on smear microscopy for
tuberculosis and its quality control in the
NTP of Bangladesh, third edition
- Revision
of National Guidelines for Tuberculosis
Control, third edition
- Reprinting
of Handbook on control of tuberculosis for
village doctors
- Reprinting
of Facilitators Guide for training of
village doctors
- Annual
report of the NTP for 2004
- Treatment
and laboratory algorithm for DOT and
Microscopic centers.
- Printing
of laboratory manual on smear microscopy for
tuberculosis and its quality control in the
NTP of Bangladesh, Bengali version, first
edition
- Printing
of brochure, flip chart, posters, stickers
- Printing
of Handbook on control of tuberculosis for
scouts
- Printing
of Handbook on control of tuberculosis for
cured TB patients, village leaders and
other volunteers
- Printing
of fact sheet on the eve of world TB
Day-2005
- Quarterly Report: 2nd and 3rd
quarter, 2005
-
Guidelines on Public Private Mix- PDF
Useful
Links
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