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Ntp

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  • 1. stop TB PakistanNational TB Control Programme Pakistan 1
  • 2. Islamic Republic of Pakistan  Population:140 million  1/3rd below poverty line  6th highest TB burden  TB Incidence: 177/100,000 2
  • 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. 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. 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. 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. 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. 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. DOTS SITUATION80%70%60%50% DOTS Coverage40% All Types30% CDR %20% Treatm ent Success10%0% 2000 2001 2002 2003 9
  • 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. 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. 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. Challenge Adequately equipped Public Health Sector DOTS In place BUT CDR and Treatment out come not achieved 13
  • 14. ResponseThere is need for broader andmore intensified collaboration involving other sectors and partners 14
  • 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. Striving for TB free future stop TB PakistanNational TB Control Programme, Pakistan 16