Tuberculosis in Nepal: Situation, Challenges and Ways Forward

Adhikari, Nilaramba; Joshi, Lok R.; Subedi, Binita; Acharya, Dilaram; Adhikari, Mukesh; Thapa, Poshan; Sultana, Rumana; Karki, Kshitij

doi:10.3126/saarctb.v17i1.25026

Cited by 11 publications

(14 citation statements)

References 15 publications

(16 reference statements)

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“…This is markedly reducing trend in comparison to the report of the study done by Adhikari N. et.al. According to Adhikari et al cases notification had contributed 20% (6677 out of 34,112 notified TB cases) of total TB cases notification in 2015 and has been decreasing thereafter (17%; 5850 out of 32,056 notified TB cases in 2016, 15%; 5216 out of 31,764 notified TB cases) in 2017) [5] . Among the positive cases, 112 (62.57%) cases were male and 67 (37.43%) were female indicating male–female ratio among smear-positive pulmonary TB cases is (1.67: 1) which is almost maintained for all age groups except for age groups ≤15 (0.75:1) and 16–30 (1:1).…”

Section: Discussionmentioning

confidence: 99%

“…Nepal being landlocked with two high TB burden countries i.e. India and China has added further difficulties to National Tuberculosis program [5] .…”

Section: Introductionmentioning

confidence: 99%

“…In Nepal, 9 out of 10 newly registered (new and relapse) TB patients are successfully treated. TB cases are decreasing but the TB mortality rate is consistently at around 3% which is unacceptably high (Male > Female) given that TB deaths are prevented if it is diagnosed on time, treated with a prescribed regimen till the end of treatment duration [5] . Mycobacterium tuberculosis is mostly transmitted by droplet nuclei produced during coughing, speech, singing or sneezing.…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary tuberculosis at Patan Hospital, Nepal: One year audit

Sah

Maharjan

Aryal

et al. 2021

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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Background Globally, Tuberculosis (TB) is one of the top 10 causes of death. In Nepal, poverty and malnutrition aggravate the burden of TB. To identify Mycobacterium tuberculosis s putum is the best sample to identify the bacterium which is helpful for diagnosis. The aim of this study is to identify the situation, burden and challenges of pulmonary tuberculosis in low-middle income country like Nepal. Method A retrospective-audit with reliable-secondary-data of one year was collected (n = 4131). Descriptive-analysis was performed using frequency, percentage and analytical using chi-square-test. Level of significance was set at p < 0.05. Ethical Approval was obtained from IRC-PAHS. Result The prevalence of notified/suspected cases was highest among the patients having >60 years of age 1344(32.54%) and least among the patients with ≤15 years of age 239(5.79%). The male had 1.67 times more smear-positive pulmonary TB cases. Among the AFB-positive cases, smear 3+ was seen in most of the cases 69(38.54%) followed by smear 1+ and smear 2+ in 56(31.28%) and 54(30.16%) respectively. Conclusion The prevalence of smear-positive pulmonary TB case is higher in male. Smear 3+ is seen in most of the followed by smear 1+ and smear 2+. The Burden of Pulmonary TB is more among adult and old-age-people and its control is a challenge for developing and low-middle income countries like Nepal.

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Section: Discussionmentioning

confidence: 99%

“…Nepal being landlocked with two high TB burden countries i.e. India and China has added further difficulties to National Tuberculosis program [5] .…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Pulmonary tuberculosis at Patan Hospital, Nepal: One year audit

Sah

Maharjan

Aryal

et al. 2021

Journal of Clinical Tuberculosis and Other Mycobacterial Diseas

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“…Likewise, people of poor socioeconomic status in India—in particular, those living in poverty—were found to have a higher risk of an increased number of TB cases than those of higher socioeconomic status, partly because of lower access to quality healthcare services [ 25 ]. Nepal is a low-income country and 25% of its population lives below the poverty line [ 26 , 27 ]. People living in rural areas face a greater risk of delayed TB healthcare and treatment due to poor TB knowledge and limited access to basic health facilities [ 15 , 16 ].…”

Section: Discussionmentioning

confidence: 99%

Assessing Factors Associated with TB Awareness in Nepal: A National and Subnational Study

Iwaki

Rauniyar

Nomura

et al. 2021

IJERPH

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Tuberculosis (TB) has still remained a serious global health threat in low- and middle-income countries in recent years. As of 2021, Nepal is one of the high TB burden countries, with an increasing prevalence of cases. This study evaluates factors associated with TB awareness in Nepal. This study uses data from the Nepal Demographic and Health Survey, a cross-sectional survey carried out from June 2016 to January 2017. Multilevel logistic regression is performed to examine the association of demographic and socioeconomic factors with TB awareness. Our findings show a high level of TB awareness in all seven provinces of Nepal. Province 5 has the highest level of awareness (98.1%) among all provinces, followed by provinces 3 and 4, while province 6 has the lowest awareness level (93.2%) compared to others. Socioeconomic factors such as wealth, education and owning a mobile phone are significantly associated with TB awareness. Socioeconomic determinants are influential factors associated with TB awareness in Nepal. The wide variation in the proportion of awareness at a regional level emphasizes the importance of formulating tailored strategies to increase TB awareness. For instance, the use of mobile phones could be an effective strategy to promote TB awareness at a regional level. This study provides valuable evidence to support further research on the contribution of information and communication technology (ICT) usage to improving TB awareness in Nepal.

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“…Moreover, a judgmental attitude towards TB patients prevents them from requesting proper care and treatment [ 30 ]. For these reasons, there is a wide gap in the identification, treatment and control of tuberculosis [ 24 ]. Thus, knowledge, awareness, and attitude are essential for improving the overall health of patients [ 30 , 31 ].…”

Section: Introductionmentioning

confidence: 99%

Knowledge on tuberculosis and utilization of DOTS service by tuberculosis patients in Lalitpur District, Nepal

2021

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Background Tuberculosis is one of the major infectious diseases and is both complex and serious. It is spread from person to person through the air, causing a public health burden, especially in low- and middle-income countries. This study aims to assess the knowledge on tuberculosis and the utilization of Directly-Observed Therapy, Short Course (DOTS) service from the public DOTS centers in Lalitpur district of Nepal. Method A structured questionnaire was used to collect data from 23 DOTS centers in Lalitpur district. Univariate and multivariate logistic regression was applied to assess the knowledge on tuberculosis and utilization of DOTS among people living with tuberculosis. Results Among 390 respondents, 80% of patients had knowledge of tuberculosis and 76.92% utilized the DOTS service from the DOTS center. People of higher age (50–60 years) [aOR; 13.96, 95% CI 4.79,40.68], [aOR; 10.84,95% CI 4.09,28.76] had significantly more knowledge on TB and utilization of the DOTS service compared to the younger group. Additionally, those who completed twelfth class [aOR; 2.25, 95% CI 0.46,11.07] and [aOR;2.47, 95% CI 0.51,11.28] had greater knowledge of Tuberculosis and utilization of DOTS compared to those who had not completed twelfth class. Likewise, compared to urban residents, respondents in rural areas (aOR; 0.51, 95% CI 0.27,0.97) had less knowledge of tuberculosis, (aOR; 0.57, 95% CI 0.32,1) and less chance of utilization of the DOTS service from the DOTS center. Conclusion Approximately one quarter of patients did not have adequate knowledge of tuberculosis and were not utilizing the DOTS service, particularly in younger age groups, people living in a combined family, with no education, poor economic position, and from rural areas. Findings of this study revealed that some specific programs are needed for enhancing the knowledge and utilization of DOTS, particularly for those patients whose economic situations extended from low to mid range.

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Tuberculosis in Nepal: Situation, Challenges and Ways Forward

Cited by 11 publications

References 15 publications

Pulmonary tuberculosis at Patan Hospital, Nepal: One year audit

Pulmonary tuberculosis at Patan Hospital, Nepal: One year audit

Assessing Factors Associated with TB Awareness in Nepal: A National and Subnational Study

Knowledge on tuberculosis and utilization of DOTS service by tuberculosis patients in Lalitpur District, Nepal

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