KATHMANDU, MARCH 24
As Nepal observes World Tuberculosis Day, it still remains a major public health problem in the country.
Globally, an estimated 10 million people contracted TB in 2019. According to National Tuberculosis Control Centre under the Ministry of Health and Population, Nepal, an estimated 68,000 people fell ill with TB during the fiscal 2019-20. Geographically, most people who reported TB were from Tarai region, that accounted for 58.7 per cent of the total number of TB patients in the region.
At the provincial level, Bagmati (24 per cent), Madhes (21 per cent) and Lumbini (20 per cent) have been infected with TB. Children comprise 34 per cent of the population, but are currently under-diagnosed with the medical condition.
"The prevalence of TB among children is around 6 per cent, while the number of infected men is nearly 1.7 times more than women among the reported TB cases," said the Protocol of National Anti-Tuberculosis Drugs Resistance Survey in Nepal (2021) published by the NTBCV.
Among 27,232 cases in the fiscal 2019-20, 22 per cent of the cases were reported by the private sector and 19 per cent by community referral.
Based on the National TB prevalence survey report and revised burden estimates, there has been a 3 per cent decline in the annual incidence rates of TB in Nepal, but the TB burden in Nepal is still higher than the previously estimated finding.
In 2018, the prevalence rate of TB was 416.35 per 100,000 population, and the incidence rate was 245.1 per 100,000 population, which was 1.8 times and 1.6 times higher respectively than previously estimated finding (National TB Prevalence Survey Report, 2018-19).
Reestimated mortality rate 3.3 times higher than earlier estimate
The mortality rates were also re-estimated to be 17,000 which was 3.3 times higher than previously estimated finding (Country profile-Nepal, Global TB Report, WHO 2020).
However, the number of deaths among registered TB patients was 1,019 (3 per cent) among 30,464 registered TB cases in the fiscal 2019-20. Among all new drug-susceptible TB cases registered in the fiscal 2018- 19, 89 per cent of them were treated successfully, with nearly 88 per cent treatment success rates for retreatment cases as well.
TB-HIV co-infection rate in Nepal is 2.5 per cent (HIV among TB) and 9.9 per cent (TB among HIV) based on the sentinel survey, 2018.
In 2019-20, 51 per cent of TB patients were tested for HIV requiring additional efforts to reach the target of 100 per cent.
The findings of the National Tuberculosis Prevalence Survey carried out in fiscal 2018-19 estimates 69,000 new TB cases annually.
Previously, it was estimated to be 44,000 TB cases per year. However, around 27,000 people affected with TB are diagnosed and provided treatment every year.
Analysis of the survey's annual estimated number of people affected with TB and the number of persons who have been diagnosed with TB and received treatment indicates great challenge for the government. It has to catch up with about 60 per cent of the people affected by TB who have to be identified and brought in for diagnosis and treatment annually.
A version of this article appears in the print on March 25, 2022, of The Himalayan Times.
