The National Tuberculosis Centre (NTC) of the government has lost track of 1,673 tuberculosis patients who were enrolled for treatment last year, posing a serious risk of the diseases spreading from the untreated patients. Tuberculosis is a serious communicable disease that claims 5000-7000 lives each year in Nepal, NTC estimate shows.

The case of missing patients was highlighted by the yearly treatment outcome evaluation report published by the NTC. Out of 37,025 people with tuberculosis on its treatment system last year, only 35,352 have enrolled for treatment this year. 

A general rule dictates that the sum of patients reported in treatment outcome should be equal to the total cases registered earlier.

Dr Bikash Lamichhane, director at the NTC, admitted the misreporting and risk associated to it. “We have asked for further verification as soon as possible,” said Dr Lamichane.  

The NTC annual report has pointed towards data mismanagement, saying “the disparity in numbers is largely due to the poor recording/reporting system (from reporting unit in community to the compiling units in the districts/regions up to the centres) that exists in the health system”.  

But experts warn that if the TB programme has lost track of patients, it could lead to a major public health disaster. While there are possibilities of those patients spreading diseases, discontinuing treatment for TB carries other risks as well. Patients diagnosed with TB are prescribed an antibiotics course lasting six months. They recuperate if they complete the course over this period. But the failure to do so results in TB bacteria developing resistance to the drugs, heightening the chances of spreading “resistance bacteria” to the general public. This mismanagement of data has raised a serious question over NTC’s policy and planning that is based on these “false data”. Interestingly, the Ministry of Health has implemented Health Management Information System, a single gateway for reporting on issues related to health by government agencies. However, the centre has not yet been incorporated into the system, as such it has been compiling data on its own. 

“It’s an irony that the NTC has been evaluating and monitoring its own programme,” said Dr Sushil Baral, a public health expert with a long experience in TB programme. “Discrepancy in data cohort has a long-term effect in policy and planning. This should be dealt with in earnest by the concerned agency.”

Meanwhile, the NTC has yet to find two patients who have not shown up for treatment since last year’s quake last year. While the NTC has put the number of lost patients after the earthquake in affected districts at 25, the two patients have been away from its radar, posing a risk of transmission.

Anil Thapa, section chief at the planning, monitoring evaluation unit at the NTC, said the two had been taking medications from treatment centres in Kathmandu. “We are trying to find their whereabouts,” said Thapa.