HMG, MOH,
Eastern Regional Health Directorate

Dhankuta, Nepal.

Field Report on

NTP International Annual Review - 2003 in EDR (Field Supervision)

 

From: Nawaraj Subba (Senior Public Health Officer)

To: Dr. Mahananda Mishra (Regional Director)

Date of Supervision: 10 -12 Aswin 2060

Place: District Public Health Office Saptari, Bhutanese Refugee camp (Jhapa), Damak PHC/ Jhapa, Dhulabari PHC/ Jhapa, Itahari PHC/ Sunsari and NATA/ Morang.

Program: National Tuberculosis Programme (NTP)

Objective of Supervision: Annual International NTP review 2003 in Eastern Region.

 

Brief Summary:

International review team for NTP in EDR visited different Health Institutions in 4 Terai districts of Eastern region Nepal. International Review Team visited Bhutanese Refugee camp (Jhapa), Damak PHC/ Jhapa, Dhulabari PHC/ Jhapa, Itahari PHC/ Sunsari and NATA/ Morang.

 

Findings:

• Private Practitioner Workshop, Rajbiraj, Saptari

Private Practitioner Workshop was held in Saptari. Resource persons from NTC, SAARC, RHD, DPHO and WHO took sessions in the workshop on the topics of NTP, Laboratory, overview of national regional and district status regarding TB programme. Mr. Gupta from NATA, Mr.Basanta Parajuli from BNMT expressed the view of necessity to add more DOT centres and sub-centres in southern belt of the district. Border VDCs have been marginalized since DOTS centres are available mostly on the highway.

 

• Bhutanese Refugee camp, Jhapa

 Refugee camp (catchments) Population = 1,02,000

 

Sputum Positive	90
Sputum Negative	12
Extra-pulmonary	43
Relapse	15
Failure	1
RAD	1
TB Incidence Rate in the camp	2/1000*
Relapse Rate	>22%*

* Calculated by reporter self on the basis of Report updated (January - August)

 

To be improved-

v     Separate room or space for smear collection.

v     Since camps having figure of high incidence of TB cases and high relapse rate that is likely to attract attention of all including concerning managers.

 

 

• Damak Sub Health Post, Jhapa

 

• Number of TB patients = 29 (Male 22 and Female 7).
• Sputum Conversation Rate = 85% and
• TB cure Rate = 94%

 

• Dhulabari Primary Health Care Centre, Jhapa

 

• No of TB patients = 31 (male 22, female 8)
• Sputum conversation rate = 97%
• Cure Rate = 92%
• To be improved – TB drugs distribution directly without keeping entry into stock book
• Need- TB modular training for Medical Officer, Smear preparation training for peon

 

• NATA Morang
• New Smear Positive Cases = 170 (Male 108, Female 62)
• New Smear Negative Cases = 199 (Male 120, Female 79)
• New Extra Pulmonary Cases = 75 (Male 38, female 37)
• Relapse  = 16 (Male 13, female 3)
• Failure = 4 (Male 1, female 3)
• Return After Default = 3 (Male 2, female 1)

(FY 2059/60)

• 3 Urban DOTS centres have been carrying out by NATA and 4 new sub-centres are going to open by partnering NGOs for different wards in metropolitan
• NATA has not been involved in HIV/AIDS programme

 

Recommendation

• Expansion of DOTS centres/ sub centres to marginalized (border, distant/ remote and resident of disadvantaged groups) population or/and areas.
• Bhutanese refugee camps require more focus on NTP.

 

cc:

1. Director of National TB Centre

Thimi, Bhaktapur, Nepal.

2. District Public Health Office, Jhapa

 

 

Submitted by-

NawaRaj Subba

Sr.P.H.O.

Eastern Regional Health Directorate

Dhankuta, Nepal

Date- 2060.6.18