In a bid to prevent tuberculosis from spreading, the Ministry of Health and Population has begun a nation-wide active case detection programme. The programme is in line with the government’s ‘End TB by 2035’ plan, according to the National Tuberculosis Centre.

“Systematic screening will be carried out to find the new and hidden TB cases,” Dr Sagar Kumar Rajbhandari, director at the National Tuberculosis Centre, told the Post. “We have already started TB screening of people in all risk groups.”

Nepal has committed to increasing investments in TB eradication. To meet the targets by 2035, the new tuberculosis infection rate should be reduced to 10 in every 100,000 population.

TB is the seventh leading cause of death in Nepal which accounts for 5,000 to 9,000 deaths every year, according to the National TB Centre. As many as 18 deaths are attributed to TB daily. Similarly, 123 new TB cases are reported daily and 27 percent of the cases (34) are missed to be reported.

To identify people with suspected active tuberculosis, tests will be carried out in the family members of TB patients, according to Rajbhandari. He said that several diagnostic tests and additional clinical assessments would be carried out on those found positive on screening, to establish the infection.

Doctors say chances of infection to other family members are high in the family having tuberculosis patients, as the disease, caused by bacteria (Mycobacterium tuberculosis), spreads from person to person as it transmits through the air.

“We will carry out tests on the family members of the TB patients, their neighbours and those who come in their close contact,” said Rajbhandari. “People having low immunity power, malnourished children, people living with HIV, patients of diabetes and alcohol users are also on our priority list.”

The centre has also assigned health workers to carry out the test on all inmates, as they are more vulnerable to the deadly disease. Most of the prisons operating within the country have been holding prisoners more than twice than their capacities and prisoners include persons suffering from TB.

Due to a lack of space and facility to isolate TB infected prisoners, the Department of Prison Management has been keeping all the prisoners in the same cell ignoring the risk of possible spread of the highly contagious disease among otherwise healthy prisoners.

The centre said that thorough tests and assessments would also be carried out on newly emerging cities, as the study has shown that the number of TB patients is high in these places. Earlier, the number of tuberculosis patients was high in Tarai districts.

The World Health Organization estimates that some 45,000 people get infected with the disease every year in Nepal. However, the National Prevalence Survey carried out recently shows that an estimated 70,000 people across the country get infected with the deadly disease.

Rajbhandari said that without new strategies and investments, the goal to end TB by 2035 cannot be achieved.

Meanwhile, the centre aims to provide Genexpert test service in all 77 districts across the country within the next two years. Genexpert test is a molecular test that detects the presence of tuberculosis (or TB) bacteria and even identifies its type. It also helps ensure that the TB drugs are working well against the disease.

Currently, there are 66 tuberculosis centres in the country that provide Genexpert test services. Over 4,000 health care centres, including hospitals, primary health care centres, health posts, and private healthcare centres, provide free treatment for TB.