Table of Contents
Introduction
- Implement NTP effectively in accordance with the spirit of federalism.
- Fulfill the Government of Nepal's commitments made at the global and regional levels to meet the End TB targets.
- The number of TB incident cases was expected to be 42,000 until 2017/18. However, the results of the 2018/19 National Tuberculosis Prevalence Survey estimate 69,000 new cases of TB, which is 1.6 times higher than previously estimated. As a result, it is critical to use more effective technology for TB diagnosis in order to eradicate the disease.
Burden of TB in Nepal:
The prevalence and incidence of tuberculosis in Nepal are higher than previously estimated. According to the National Tuberculosis Prevalence Survey 2017/18, the TB prevalence rate is 416/100,000, which is 1.8 times higher than the WHO's previous estimate, and the revised incidence rate is 245/100,000, which is 1.6 times higher. TB mortality rates have also been re-estimated to be 3.1 times higher than previously estimated, while TB drug resistance is 1.6 times higher than previously estimated.
TB notification
In 2018/19, 32,043 new and relapse TB cases were reported. The rates of tuberculosis notification were found to be lowest in the mountains to the north of the country and highest in the Terai plains to the south. Given the ratio of new incidence to prevalence rate, it is critical to bring 14 percent of TB cases into the treatment continuum.
TB Mortality
Despite the fact that Nepal lacks a functioning Vital Registration System that provides direct or real-time information about TB-related deaths, data on TB-related deaths have been estimated based on the TB Prevalence Survey and WHO data, which is 58 per 100,000 population annually.
National Strategic Plan to end Tuberculosis: 2021/22-2025/26
Vision
TB free Nepal
Goal
Nepal has set a goal to decrease incidence rate from 238 in 2020/21 to 181 per 100,000 population by 2025/26; decrease mortality rate from 58 in 2020/21 to 23 per 100,000 by 2025/26; end TB epidemic by 2035; eliminate TB by 2050; and reduce the catastrophic cost to zero.
Objective
- To build and strengthen political commitment, sustainability and patient-friendly health system to end TB.
- To ensure the identification of TB, diagnosis, quality treatment and prevention.
Strategies and policy Actions
Strategy 1:
Improve the quality of TB services and strengthen the health system for universal access to TB services; effectuate the TB services and support by increasing the community engagement in TB management, and strengthen the digitalized case-based surveillance system in health care facilities.
Policy Action
1.1. Provide quality TB services through increased universal access to health care by further strengthening the health system of TB program
1.2. Strengthen community involvement and ownership in TB free Nepal Campaign
1.3. Strengthened monitoring system of TB program
1.4. Ensured implementation of TB programs through integrated health system for its sustainability during natural disasters and other emergencies.
Strategy 2:
Strengthen laboratory services to further improve the management of TB diagnosis and treatment.
Policy Action
2.1. Strengthened TB Laboratory Services
Strategy 3:
Quality Improvement of the services for TB prevention, identification and treatment
Policy Action
3.1. Increased rate in identification of patients of DSTB and DRTB
3.2. Increased TB treatment success rate
3.3. Expanded TPT coverage and strengthen Infection Control Measures at all health facilities
3.4. Implementation of multisectoral approach and addressing of high risks due to TB comorbidities
3.5. Ensured meaningful participation of private and non-government sector for effective management of TB services
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