PESHAWAR, Feb 7: Officials of the Afghan TB control programme have asked the refugees to receive the transfer-out-cards before going back to Afghanistan to avoid spread of the epidemic back home.

According to the officials, elaborate arrangements for Afghan TB patients had been made to give them transfer-out-cards at the healthcare facilities at their respective camps, so that they could continue their treatment back home.

"As TB needs treatment for eight consecutive months. Some of the refugees while leaving for Afghanistan forget about the importance of their treatment and subsequently get multi-drug resistance TB, which is incurable", said Dr Akmal Naveed, Managing Director of Association for Community Development (ACD), TB control programme for Afghan refugees in NWFP.

He said that some of the patients, do not visit the doctors at the ACD and other health facilities before repatriation to get necessary information regarding the status and treatment of their ailments. This, he said had increased the chances of inflicting the disease to other normal people in their household and neighbourhoods.

Dr Akmal said that two hospitals, 98 basic health units (BHUs) and 47 laboratories have been catering to the needs of 1.3 million refugees in the province, wherein about 10,200 patients have been diagnosed with 65 per cent pulmonary and 35 per cent extra- pulmonary TB in the last three years.

Treatment is being provided under Dots (directly observed treatment short course) for eight months, but discontinuation of treatment lead to severe complications.

These included 60 per cent women and 40 per cent men, whereas 3,000 of them happened to be sputum positive, which is more infective. About 75 per cent were in age group of 15-54 years and five per cent below five years of age. Seventeen people died of TB in the last three years.

Apart from the camps, about 10-15 per cent of the refugees living in urban areas visit the hospitals and private clinics and therefore no record concerning the prevalence of TB among them was available.

The TB control programme is implemented by primary healthcare services infrastructure for Afghan refugees, whereas the ACD, HNI provide technical support for capacity building through training and monitoring of the personnel of the other organizations, working at the camps, to ensure quality of services, coordinate their activities and provide logistic support to ensure smooth sailing of the programme.

Besides provision of diagnostic facilities to the Afghan refugees in camps, it has also been supporting the WHO-sponsored TB control programme in Afghanistan, provincial and national TB control programmes by imparting training to doctors, paramedics and laboratory technicians with the help of 20 staffers.

"We have so far trained 273 doctors, 217 laboratory technicians, 1,800 social workers and 66 dispensers. Similarly, refresher courses are also being arranged for their capacity building", said Dr Akmal. He said that the ACD's aim was to decrease TB mortality and level of transmission in refugees through uninterrupted supply of quality drugs and laboratory equipments to all the outlets.

Dr Akmal said that they had developed transfer-out-cards for the Afghan refugees since the start of repatriation programme in March 2002.