TB – NTCP

Program Overview – Tuberculosis

The Global Fund against HIV, Tuberculosis and Malaria funded program for Tuberculosis is managed by National Tuberculosis Control Programme, Communicable Disease Division, Department of Public Health, Ministry of Health in Bhutan.

National Tuberculosis Control Program under the Department of Public Health started in the year 1986. NTCP is responsible for programming, planning, resource mobilization, monitoring and evaluation. National Referral/ Regional Referral and District hospitals diagnose and start the treatment for TB.  The health workers in the basic health units report cases, follow up and refer TB suspects to the district hospitals for confirmation.

In 1991, a tuberculin survey measured the annual risk of tuberculosis infection to be 1.5%. Bhutan piloted Short Course Chemotherapy (SCC) in three districts in 1994 and was implemented nationwide in the same year. In 1997 the Directly Observed Treatment Short Course (DOTS) strategy was adopted nationwide.

Bhutan has an annual incidence of 91 cases of all forms of TB /100 000 population. The case detection rate has been steadily increasing each year and was over 100% in 2007. The treatment success rate achieved for the cohort of the patients registered in 2006 was 89%.

There is no representative data on levels of drug resistance. However, it is estimated that 0.6% of newly diagnosed smear positive TB cases have MDR-TB. Currently, there are very limited laboratory facilities for culture and drug susceptibility testing (DST) in the country. Culture and DST facilities will be upgraded at the Jigme Dorji Wangchuck National Referral Hospital at Thimphu and additional laboratory staff trained in undertaking quality-assured culture and DST. It is proposed that DST will be done for all Category II failures through assistance from the designated SNRL, until the national laboratory is set up, when DST may be extended to all smear-positive cases initiated on treatment. The national programme has applied to the Green Light Committee in 2008 for second-line drugs and management of MDR-TB.

Major challenges:

  • Limited management capacity at the central level;
  • Need to strengthen TB surveillance including data management;
  • Inadequate access to diagnostic and treatment facilities among people living in the border and remote areas, and
  • Migration of people with TB freely across the open border withIndia

Through the Global Fund support, the NTCP has implemented Round 4 and Round 6 and TFM (current grant). The program has been successful in carrying out the ARTI survey to better estimate incidence of the diseases and conduct IEC programmes on tuberculosis to further improve community awareness and reduce the TB prevalence.

For more information on the program please click here.

 

Contact person(s) :

Mr Chewang Rinzin
Deputy Chief Program Officer, NTCP, DoPH
Ministry of Health Building
Kawajangsa
P.O.Box# 726
Thimphu
Bhutan
Telephone: +975 17718208
Email: crinzinc@gmail.com / crinzin@health.gov.bt

Mr Tashi Dendup
Program Officer, NTCP, DoPH
Ministry of Health Building
Kawajangsa
P.O.Box# 726
Thimphu
Bhutan
Telephone: +975 17612647
Email: tashid425@gmail.comtashidendup@health.gov.bt