Ntp

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Ntp

  1. 1. stop TB PakistanNational TB Control Programme Pakistan 1
  2. 2. Islamic Republic of Pakistan  Population:140 million  1/3rd below poverty line  6th highest TB burden  TB Incidence: 177/100,000 2
  3. 3. TB Situation in Pakistan• Major public health problem• Harbors 43% of disease burden in EMR/WHO• 250,000 new cases every year• 75% of patients between the age group of 15 – 59 years• Social stigma 3
  4. 4. TB Control Programme: Historic Review 1960s Program launched 1980s Dormant programme 1995 DOTS strategy adopted 1996 TB Directorate abolished 1998 TB integrated with PHC – Roles and responsibilities redefined 2000 NTP revived to operationalize DOTS strategy in the country 2001 National Emergency - Islamabad declaration 4
  5. 5. NTP OBJECTIVES National policy, strategic and operational guidelines District capacity building for DOTS Training, supervision and monitoring Advocacy and community mobilization Quality assured microscopy network 5
  6. 6. NTP OBJECTIVES Partnership building:  International technical and financial partners  Inter-sectoral and intra-sectoral collaboration  Public-private partnership for enhanced case detection and treatment outcomes.Operational Research  program decisions 6
  7. 7. DOTS STATUS PAKISTAN 2000 till 2003 Year 2000 2001 2002 2003Total population (Thousands) 141,256 142,435 145,385 151,677Population covered by DOTS 12,713 38,139 50,544 95,478(Thousands)DOTS population coverage % 9% 26% 35% 63%Estimated Cases of Pulmonary TB 110,180 113,077 111,881 116,791Smear positive *Cases notified in DOTS areas 11,050 19473 38337 68,715(all Cases)Cases notified in DOTS areas 3285 6441 12,621 19,894(Smear Positive)Treatment success rate under 75 76 72**DOTS ( % )DOTS Case detection rate for new 3 6 11 17smear positive ( % )* Estimated Cases of Tuberculosis All types : 171/100,000 popn. ** till Q4 2002 7 Pulmonary Smear +ve : 77/100,000 popn.
  8. 8. TB Situation :Case NotificationDOTS Areas Case Types Notified 2003 Relapses Others 2% NSS+ EPTB 29% 4% 17% NSS+ NSS- EPTB Others Relapses NSS- 48% 68715 cases 8
  9. 9. DOTS SITUATION80%70%60%50% DOTS Coverage40% All Types30% CDR %20% Treatm ent Success10%0% 2000 2001 2002 2003 9
  10. 10. Achievements• PARTNERSHIP DEVELOPMENT • IACC • Drugs received from GDF (153,100 patients) • GFATM (BCC and NGO Support) • Provincial Referral Laboratories Strengthened • Additional BCC Funding – GoP. • Additional Support for Developing Public & Private Partnerships (DFID,WB) • FIDELIS (Intersectoral Collaboration, Tertiary Care Hospital, NGO Support ) • District Capacity Building for DOTS (USAID/WHO) • CIDA –reaching poorest of poor( Through LHWs )• STOP- TB PAKISTAN 10
  11. 11. Future plans Strengthen Smear Microscopy Q/A system. Resource gaps in Public-Sector DOTS expansion Build district capacity to consolidate and sustain quality DOTS Strengthen Drug Management / QC Cont….. 11
  12. 12. Enhance case detection & Treatment Outcome by:  Strengthening community mobilization  Involving NGOs & private practitioners  Involving Tertiary Care Level Hospitals in DOTS  Promoting sector-wide approach in DOTS (Social Security, Police, WAPDA, Railways etc)  DOTS in migratory populations (Nomads, Afghan refugees) 12
  13. 13. Challenge Adequately equipped Public Health Sector DOTS In place BUT CDR and Treatment out come not achieved 13
  14. 14. ResponseThere is need for broader andmore intensified collaboration involving other sectors and partners 14
  15. 15. ISAC Involvement of District Government local opinion/community leader Infra structure available (devolution) >100,000 councillors  To mobilise local political support.  To enhance public and political perception of TB and DOTS.  To increase TB awareness throughout Pakistan  Proposal Submitted to mobilize communities . 15
  16. 16. Striving for TB free future stop TB PakistanNational TB Control Programme, Pakistan 16

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