KARACHI, Sept 28: A meeting of the Provincial Development Working Party, presided over by additional chief secretary (development) Sindh, Ghulam Sarwar Khero, extended the Tuberculosis Control Programme till June 2006 at a total revised cost of Rs149.035 million.

The programme objectives that are in line with the regional and national targets for TB control set by the World Health Organisation (WHO) include enhancing the case detection rate of tuberculosis patients to 70 per cent of the estimated incidence by the year 2005.

They also include increasing the treatment success rate of the newly diagnosed tuberculosis patients to at least 85 per cent in all the districts of Sindh, and thereby reducing the prevalence and deaths due to tuberculosis by 50 per cent by the year 2010.

The meeting was attended amongst others by M. Iqbal Deewan, additional secretary health, Fazal Ahmed Nizamani, chief health and nutrition, Dr Nazir Ahmed Sheikh, director TB control Sindh, Muhammad Umer Abro, additional director development, and health and other senior officers.

WHO was represented in the meeting by Dr Ghulam Nabi Kazi, provincial operations officer for Sindh, and Dr Amanullah, national programme officer TB control Sindh.

The PC-1 was previously approved in July 2000 at a cost of Rs95 million. However, some savings were affected due to receipt of drugs from the Global Drug Facility and a total expenditure of Rs59.035 million was incurred till June 2003. For the next three years, an expenditure of Rs90.768 million has been projected.

The bulk of this amount will be spent to ensure uninterrupted availability of quality and tuberculosis medicines, laboratory material for sputum testing and recording and reporting material. Other components include training (including refresher courses), supervision and monitoring strengthening of the laboratories at the Institute of Chest Diseases Kotri and TB Hospital Khairpur, social mobilization and health awareness materials.

It may be mentioned here that a provincial referral laboratory has already been established at the Ojha Institute of Chest Diseases, largely with the support of the National TB Control Programme (NTP), while intermediate level referral laboratories for quality control and supervision of laboratory services at the district level will be established at the Institute of Chest Diseases Kotri and the TB Hospital Khairpur.

WHO operations officer for Sindh, Dr Ghulam Nabi Kazi, praised the commitment of the government of Sindh in sustaining the activities of this major preventive programme.

He stated that universal DOTS coverage would be achieved in Sindh soon, as training of care-provider was already under way in the two remaining districts of Thatta and Sanghar.

He emphasised that the main thrust of the programme was on making DOTS more comprehensive by involving autonomous bodies, federal government health institutions, tertiary care hospitals, social security organizations, centres run by NGOs and other private sector organizations.

Ultimately general practitioners in the private sector would also be trained in the DOTS methodology, Dr Kazi said.

WHO national programme officer for TB control Sindh, Dr Amanullah, stated that the provincial government had a well-established organizational structure in urban and rural areas, which needed to be strengthened.

He said the existing facilities and institutions involved in TB control activity included two chest institutes, one TB hospital and 206 diagnostic centres for tuberculosis in the province.

He stated that tuberculosis was a major public health problem in Pakistan and WHO had estimated the incidence of all types of TB cases at 171 per 100,000 population in Pakistan. He added that seventy-five per cent of TB patients were concentrated amongst the most economically productive age group of 15-59 years.

He continued: “Although the cure rate of detected cases has increased to 73 per cent from 30 per cent following the introduction of the DOTS strategy in the province, it is still below the requisite target of 85 per cent. Similarly, the case detection rate is still well below the target of 70 per cent detection of existing cases, warranting involvement of the private sector and other organizations. Dr Ansari further said that WHO would support operational research in tuberculosis control and several studies would be carried out during the course of the project life.

The WHO’s regional office has approved a study on the correlation of tuberculosis and poverty and the role organized communities in enhancing case detection and treatment success rates.

Dr Syed Karam Shah, Dr M. Assi Ardakani, Dr G.N. Kazi and Dr Hasan Sadiq will conduct the study under the overall supervision of the WHO representative to Pakistan, Dr Khalif Bile Mohammad. The study will be conducted in the area of operation of the multi-sectoral Basic Development Needs Programme. — APP