Situation of TB in Sankhuwasabha district of Nepal
Sankhuwasabha is one of the mountainous districts located at the base of Mt. Makalu and extended with Arun, Barun, and Sabha rivers in Eastern Nepal. It has got area of 3480 Sq.Km. and population 141903 (Census 1991). Southern part of this district is dense and fertile whereas northern part of the district is mostly mountainous and has less population. Different caste and ethnic are habitat and there is eminently socio-economic and cultural diversity in the district.
Source: Annual Reports of DoHS
If we analyze the data of Case finding Rate and Cure Rate of TB in Sankhuwasabha district; the trend is in increasing trend. Case Detection Rate was 31% in F.Y.1994/95 has reached at 53% in F.Y.2000/2001. Similarly Cure Rate was 36% in F.Y.1994/95 has been reached 89% (BNMT) in FY 2000/2001 in the Sankhuwasabha district. But t level of trend is almost below than national objective.
Death from TB has been reported even in the age of 11 years in this district. The trend of Case Finding Rate and Cure Rate is increasing year by year in the figure but the newer problems for TB control program has encountered as challenge in the district. On the one hand, Sputum slides have not been collected enough from the HPs due to inadequate manpower and low motivation. Some TB treatment centres are inactive and they are failing to keep maintain drug available. Supervision of all Health Institutions has been inadequate. Proper recording and reporting is being difficult in health institutions. It has been reported that the quality of slide examination in the center is also deteriorating. On the other hand we have also more than 7 VDCs which are vulnerable to HIV/AIDS. And one HIV/AIDS case has been died in the tourist trekking VDC in the district recently. There is lots of underlying pre-disposing; enabling and re-enforcing factors responsible for those problems.
There are also some possible solutions for these problems in the district. Efforts should be focused to the district and emphasis should be given at VDC level in the process of planning, monitoring and evaluation of TB program. There is good reporting and evaluation status of TB program at regional and central level. And now it is time to involve district and VDCs for planning, review and regular evaluation of TB program for making them more responsible in order to change the district and national figure as well.
Feedback: [email protected] ©2002. Nawaraj Subba, MPH.