KARACHI, July 19: A 40 per cent increase in case detection rate of smear positive patients in April-June period this year, as compared to 30 per cent in the corresponding period last year , well reflects that success of efforts towards control of TB in Karachi.

Dr Ghulam Nabi Kazi, Operation Officer, Sindh, of the World Health Organization (WHO), speaking here on Monday about the July 23-24 workshop on TB control, described the progress a 'very positive development'. He mentioned that the sputum conversion rate and treatment success rate had also risen to 82 per cent and 80 per cent respectively during the second quarter of the current year.

It may be recalled that the Tuberculosis Control Programme is being implemented across the province by the Sindh Health Department in collaboration with the WHO. Dr Kazi also referred to the WHO Global Tuberculosis Control Report-2004 which noted that in Pakistan, the overall detection rate of sputum smear positive cases, that can transmit the disease to others, had risen from two per cent in 1999 to 13 per cent in 2002.

"The current figures, however, indicate that we have made significant progress in Sindh over the last two years, particularly in the last year," Dr Kazi said. Sindh had achieved universal DOTS coverage in 2003 only two years after TB was declared a 'national emergency' in Pakistan.

Dr Kazi mentioned that the new WHO report placed Pakistan at six on the list TB burden countries in the world and estimated that 271,500 cases appeared every year and 121,500 of them come out to be smear positive.

The total prevalence of smear positive cases in the country has been estimated at 267,000 while the mortality on account of TB has been worked out at 67,500 annually. Both the above figures have to be brought down by half by the year 2010. Similarly, the process targets of 70 per cent case detection of smear positive cases and successfully curing 85 per cent of them seem to be quite an uphill task at present.

Dr Kazi pointed out that keeping in view the fact that a sizable percentage of TB patients initially sought treatment from private sector in Karachi, networking had been carried out with several NGOs and in collaboration with them, 22 centres had been established across the city.

The Directorate of TB Control, Sindh, is providing free drugs, received through the Global Drug Facility, to these centres in order to strengthen certain major NGOs such as Aga Khan Health Services Pakistan that had received a grant through the Global Fund for AIDS, TB, Malaria (GFATM) and the centres are also expected to initiate case detection on a daily basis.

Dr Amanullah Ansari, WHO's National Programme Officer for TB Control in Sindh, pointed out that at present, 33 TB diagnostic centres in public sector and seven in private sector were functional and reporting in Karachi.

He mentioned that during the second quarter of 2004, a total of 2,308 TB cases had been registered in Karachi. Among them were 989 smear positive, 82 relapse, 207 re-treatment, 606 smear negative and 424 extra pulmonary cases.

The patients were 1,100 male and 1,208 female, he said, mentioning that this reflected a positive trend in the programme implementation. The Ojha Institute of Chest Diseases, which is a premier institution for TB treatment in the city, detected 1,258 patients through its five clinics located in various towns of the city.

Dr Amanullah Ansari noted that while the indicators were still falling short of achieving the targets, there was every hope of success by December 2005. He highlighted the need for an improved monitoring and supervision, developing of 'working linkages' of diagnostic centres with treatment centres, effective quality control mechanism for sputum microcopy, training of supervisors on the newly-developed module and ensuring greater participation of women health workers as treatment supporters in the programme.

It was hoped that all these problems would be addressed in the workshop scheduled to be held on July 23 and 24 in Karachi and which would be attended by provincial Health Secretary Ashiq Hussein Memon, National Programme Manager for TB Control Dr Syed Karam Shah and the Director General of Sindh Health Services, Dr Hussain Bux Memon and others.

Dr Iqtedar Ahmed, Director TB Control, Sindh, and other senior consultants from the National TB Control Programme and WHO are also expected to attend the workshop. -APP