TB control programme hits snag

The National Tuberculosis Control Programme (NTCP) is still facing challenges like lack of mass awareness, increased industrialisation, malnutrition and environmental pollution, intensifying the risk of spreading the deadly disease despite Bangladesh's remarkable success in combating TB.
During a recent visit to Brac office at Shawgat in Rupganj upazila of Narayanganj district, this reporter found that both TB case detection and success rates increased over the years. But field level officials of Brac TB programme identified various challenges which hamper success of the TB control programme.
In Rupganj there were 328 smear positive patients in 2013, of whom 315 were cured. The success rate was 96 per cent. In 2014 the number of smear positive cases was 303. Of them, 290 were cured and the success rate was 96 per cent.
In the same upazila there were 581 patients of all TB types and of them, 559 were cured (success rate 96 per cent) in 2013. But in 2014 the number of TB patients of all types was 610, of whom 590 were cured (success rate 97 per cent).
The number of total registered patients increased to 629 in 2014 from 610 in 2013.
In Narayanganj there were 4,462 TB patients in 2013 and 4,313 were cured, putting the success rate at 97 per cent. In 2014 a total of 4,860 TB patients were detected.
Brac activists said the rate of cured patients and diagnosis has increased in the district as TB programme workers remain active in carrying out their activities including door-to-door communication, monitoring of records, treatment cards, orientation of paediatricians and garment workers and other industries, screening of children who live around any smear positive patient etc.
Though there is hardly any social stigma right now, there is lack of social awareness programmes on hygiene and malnutrition, they observed.
Besides, overcrowded working environment in industrial area increases the risk of spreading TB faster. Poverty is another challenge as they remain malnourished and live in unhealthy environment which are the causes of attack of the disease.
Big garment units allow their workers to take part in the orientation programme which Brac organises quarterly. These workers are advised to use masks during working hour and be cautious while sneezing or coughing and make others aware about TB.
The owners of the garments are also advised to continue his or her job if they are attacked with TB.
The garment authority grants leave of absence in case of a smear positive patients as they usually become smear negative after taking medicines for 45 days.
Line Director of TB-Leprosy Dr Md Ahmed Hussain Khan told the FE that the rate of sputum positive TB patient is 68 per cent in Bangladesh lower than the global target of 70 per cent. The rate of TB patient detection is 122 per 0.1 million.
He noted that the case detection will rise if more GeneXpert machines can be installed in more districts.
The Xpert MTB/RIF test is a new molecular test for TB which diagnoses TB by detecting the presence of TB bacteria, as well as testing for resistance to the drug Rifampicin.
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