Report On Activities Organized On World TB Day 2003

Many Important steps mark the history of tuberculosis (TB) since the discovery of Mycobacterium tuberculosis on March 24, 1882 by Robert Koch. That discovery made possible the diagnosis & treatment of TB. In 1982, on 100th anniversary of Dr. Koch’s discovery, the 24th March has been declared as the official TB day.

Tuberculosis has been a grave health problem in Bangladesh with adverse social & economic consequences. More than 3,00000 new cases of TB occur in Bangladesh every year, half of them are infectious & therefore spreading the disease in the community. Though we have very effective treatment modality still TB remains the first killer disease of adults. Moreover the maximum morbidity & mortality from TB is borne by the most economically productive age group (15-45 yrs) of our society. Around 70,000 people die because of TB every year in Bangladesh. Bangladesh stands fifth among the high TB burden countries in the world.

In April 1993 World Health Organization (WHO) declared TB as global emergency & promoted Directly Observed Treatment Short Course (DOTS) as strategy for controlling mortality, morbidity, transmission & to prevent multi-drug resistance of TB.

To combat TB problem in Bangladesh The National TB Control Programme adopted the WHO recommended DOTS strategy in 1991 with assistance from World Bank Consortium, The Netherlands & technical support from WHO. Since July 1998, The National TB Control Programme has been implemented under the Communicable Disease Control of the Essential Service Package (ESP), which is under the Health & Population Sector Program (HPSP). By the end of the year 1998 the NTP services were made available in all 460 Upazila Health Complexes. Since December 2002 TB control services are available in 605 centers throughout the country including urban dispenceries of 4 metropolitan cities (Dhaka, Chittagong, Rajshahi, Khulna).

It is crucial for involvement of NGOs/private organization to take up the TB control & develop effective initiative to combat this disease. Realizing this many NGOs became partners of the National TB Control Programme. Out of 460 upazilas Health Complexes 259(56%) Upazila are covered through the collaboration with NGOs, and the remaining 201(44%) directly by the Government. Many NGOs of UPHCP are collaborating with the program in the municipalities & metropolitan areas. At present about 95% of the population of Bangladesh are covered by DOTs services.

Since its inception, the revised National Tuberculosis Control Programme has achieved 84% success rate against the target of 85% by the year 2001, but case detection rate is still not encouraging, as 34% cases (sputum positive) has been detected against the target of 70% as of 2002. Since the starting of registration under NTP till December 2002 the cumulative number of reported TB cases are 5,65,408. The total number of 81,795 TB cases was reported under NTP in 2002, out of them 46,747 were new sputum smear positive and 2,478 were sputum smear positive relapse patients.

The Government of Bangladesh, together with its old & new partners (Medical colleges, Post Graduate Institutes, Chest Hospital, Prisons and work place etc.) intends to intensify the DOTs program in order to achieve its target of case detection (70%) & cure rate (85%) among the sputum smear positive pulmonary TB cases in near future.

Observance of World TB Day every year implies big advocacy for the NTP throughout the country. The theme for World TB Day 2003 is " People with TB" & the slogan is " DOTs cured me- it will cure you too!". This highlights the need to involve people with TB as advocates & active participants in TB control. It is crucial to adopt effective strategy at all stratum of society to raise public awareness & develop health care seeking behavior for physical symptoms suggestive of tuberculosis. It is expected that in near future NTP will be able to achieve its target in control of tuberculosis through strong commitment & partnership between government & its partners.

In observance of the World TB Day 2003, the following activities were done.

  1. Fact sheet on tuberculosis was published by the NTP. It includes the Followings:
    1. Theme & the slogan for World TB Day 2003.
    2. It describes how TB is transmitted & who are the suspects. It explains the global picture of TB as well as Bangladesh also.

    (c) Objectives of the National TB Control Program in Bangladesh

    (d ) DOTS strategy

    (e) Services of the program & collaboration with the partners.

    (f) Achievements of the program till December, 2002

    (g) The fact sheet also gives us the picture of economic impact of tuberculosis in the society.

  1. Script preparation for radio and television broadcast: It includes the detailed explanation of theme and slogan for World TB Day ,2003. The script reflects this year’s World TB Day slogan, "DOTS cured me- it will cure you too!" which is appropriately patient-centered , aimed at mobilizing cured TB patients to motivate those with TB to access effective treatment under DOTS.
  2. News at daily news paper on World TB Day : The news of observance of World TB Day was published in main national dailies highlighting the theme & slogan of World TB day,2003 (The paper cuttings are attached herewith).
  3. Presentation at scientific seminar on World TB Day, 2003.

A seminar was held at the auditorium of the National Institute of Diseases of Chest & Hospital at Mohakhali, jointly organized by the Chest & Heart Association of Bangladesh and BRAC(Bangladesh Rural Advancement committee), an NGO and sponsored by the pharmaceutical company, Novartis. The seminar was chaired by the Director, NIDCH & President of Chest & Heart Association of Bangladesh. The seminar was also addressed by the Director PHC & line Director ESP, DGHS, Deputy Director CDC & National Program Manager for TB , DGHS. All officials of NTP attended the seminar besides many doctors from NIDCH & different NGO partners. Deputy Director CDC & National Program Manager for TB declared the commitment of the Govt. to control TB and asked for all out cooperation from all concerned to perform the remaining task of TB control.

(5) The NGO partners of NTP also observed the World TB Day, 2003 in a befitting manner.

The following were also done:

  1. Rallies of cured and current TB patient groups
  2. Collection and distribution of success stories of cured TB patients
  3. News at daily news papers and publication of fact sheet by NTP
  4. Scientific Seminar on Tuberculosis
  5. Open new DOTS clinic
  6. Forum to talk to patients/patients associates

Advocacy meetings with cured patients followed by rallies of current and cured TB patients

Damien Foundation Bangladesh (DF) observed "World TB Day 2003" in 13 districts in line with the global theme ‘DOTS cured me – it will cure you too’. On this occasion, the foundation organized advocacy meetings with cured patients in all 13 districts where the program is being implemented by the organization. The advocacy meetings at the districts were presided by the civil surgeons. The local health authorities, community elites and journalist from local newspapers also attended the meetings. A PowerPoint presentation was made on the theme of involvement of cured patients.

During the discussion the cured patients testimonies their sufferings with the disease, how they were detected/treated finally became cured and now enjoying the benefit of being cured. The success stories of two patients are also attached herewith. At the end of the advocacy meetings the former patients were committed to continue an ongoing campaign for identifying suspected cases of TB and also to provide DOT to newly detected patients. After the discussion sessions rallies were conducted with banners and festoons with the participation of cured and current patients, local health officials and other elites.

Advocacy meetings with cured patients followed by rallies of current and cured TB patients in Khulna city

Khulna is a metropolitan city. GOB is implementing urban TB control program in collaboration with several NGOs. At present the NGOs working Paribar Kallyan Samity (PKS), Fair Foundation (FF), Pime Sisters observed World TB Day, 2003 in Khulna city in collaboration with Government health official of Khulna.

Key points of the program observed are as follows:

  1. For several days there were meetings arranged in schools, street corners, shopping centers and crowded spots. In those meetings cured patients were present and spoke on TB and DOTS.
  2. Leaflets containing message on TB were distributed among people and students
  3. Banners and posters were hanged in all TB treatment centers, Hospitals and Medical College highlighting the theme and slogan of World TB Day.
  4. Information, orientation and advocacy meetings by NGOs in all their clinics and other spots.

News at daily news paper on World TB Day

The news of observance of World TB Day was published in main national dailies highlighting the theme & slogan of World TB day,2003 (The paper cuttings are attached herewith).

Publication of fact sheet by NTP: Fact sheet on Tuberculosis was published by the NTP. It includes the followings:

  1. Theme & the slogan for World TB Day 2003.
  2. It describes the basic facts about Tuberculosis and identification of suspects.
  3. Achievements of the program till December, 2002
  4. The fact sheet also gives us the picture of economic impact of Tuberculosis in the society.

Scientific Seminar on Tuberculosis Organized By Chest and Heart Association of Bangladesh (CHAB)
&
Bangladesh Rural Advancement committee (BRAC)

BRAC and Chest and Heart Association of Bangladesh (CHAB) jointly organized a scientific seminar on Tuberculosis in Dhaka on 24th March 2003 to mark the World TB Day. In the seminar, about 300 prominent chest specialists, chest physicians, internal medicine specialists, NGO activists and workers, pharmaceutical, development partners and media personnel (electronic media and news papers) were present. In the seminar, current situation of tuberculosis and NTP achievements were presented by Dr. Jalal Uddin Ahmed, Program Manager, CDC, DOTS through community health workers were presented by Dr. Md. Akramul Islam, Sr. Sector Specialist (TB), BRAC. Cured patients explained their experience of DOTS through community health workers and their contribution to find-out new cases and motivation to patients for treatment. Dr. Asif Muztaba Mahmud, Assistant professor, National, Institute of Diseases of Chest and Hospital (NIDCH) presented the facilities and activities of NIDCH. He stressed the need of collaboration between NTP and Academic institutes. Dr. Pankaj Kumar Nath, Field Director, Damien Foundation, shared the experience of cured patient in case finding as they are advocating for DOTS. At village, upazila (sub-district) and district levels yearlong social mobilization campaign has been planned and orientation of community members, cured patients, opinion leaders, and private medical practitioners by BRAC in collaboration with Government of Bangladesh is under implementation

Opening Ceremony of New DOTS Clinic

It was the World TB day on 24th March 2003. To provide free TB diagnosis and treatment as partner of NTP, Nary Matinee, an NGO under Urban primary Health Care Project arranged a program on that particular day. Chief guest of the ceremony was Deputy Director CDC & National Program Manager of TB. Local ward commissioner and other local elites were also present on the occasion. Distinguished officials from Urban Primary Health Care Project (UPHCP) were also present on this opening ceremony of TB control program. On this opening day 10 suspected patients were present in the clinic for sputum smear examination. Nari Maitree has started the TB control program through the five health care centers

Forum to talk to patients/ patients associates about the potential for their involvement in DOTS treatment and TB control

Progoti Samaj Kallayan Protisthan (PSKP) under Primary Health Care Project (UPHCP) organized a discussion meeting at Jahurul Islam Primary Health Centre on 24th March 2003 in connection with the observance of World TB Day, 2003. Thirty TB patients (both cured & under treatment) and their relatives were present on the occasion. The meeting was presided over by the Project Manager UPHCP & the clinic manager of the Primary Health Care Centre took part in the discussion meeting. The speakers spoke about basic health education & public awareness on primary symptom of Tuberculosis. Two cured TB patients who took medicine from this centre explained their experience in the meeting & inspired the other TB patients. Besides another motivation meeting was held at a home for destitudes under the ministry of social welfare at Mirpur.

Report of Progoti Samaj Kallayan Protisthan And Poribar Porikalpana Sangstha (PSKP)

Progoti Samaj Kallayan Protisthan (PSKP) under Primary Health Care Project (UPHCP) organized a discussion meeting at Jahurul Islam Primary Health Centre on 24th March, 2003 in connection with the observance of World TB Day,2003. Thirty TB patients (both cured & under treatment) were present on the occasion. The meeting was presided over by the Project Manager UPHCP & the clinic manager of the Primary Health Care Centre took part in the discussion meeting. The speakers spoke about basic health education & public awareness on primary symptom of tuberculosis. Two cured TB patients who took medicine from this centre explained their experience in the meeting & inspired the other TB patients. Besides another motivation meeting was held at a home for destitudes under the ministry of social welfare at Mirpur.

Urban Primary Health Project(UPHCP)
Nari Maitree

Nari Maitree is a non-government development women organization. The organization was established in 1983 by a group of woman activist in order to build the capacity of women, children and adolescent for establishing their rights in the society.

Nari Maitree took part to serve health care program through Urban Primary Health Care Project since 2001. This program includes 7 primary health care centers. These centers serve health care facilities to the lower socio economic group of people.

Opening Ceremony of TB control program

It was the World TB day on 24th March, 2003. To provide free TB diagnosis and treatment as partner of NTP, Nari Maitree arranged a program on that particular day. Chief guest of the ceremony was Deputy Director CDC & National Program Manager of TB. Local ward commissioner and other local elites were also present on the occasion. Distinguished officials from Urban Primary Health Care Project(UPHCP) were also present on this opening ceremony TB control program. On this opening day 10 suspected patients were present in the clinic. Nari Maitree has started the TB control program through the five health care centers.

 

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