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Prevalence of
Tuberculosis (TB) in Sri
Lanka is low in comparison to other
countries in South East Asia (SEA).
Multi-drug resistance levels and incidence of TB-HIV are also
low. Key achievements of the National
TB Programme are that both case detection and
treatment success global targets have been reached and sustained mainly due
to good implementation of Directly Observed Treatment Strategy (DOTS). The
overall default rate has dropped to over 12% to 6% within five years due to
intensified default tracing efforts involving all the categories of health
staff at field level.
An external
review of the National response to TB control was organized with the
following objectives:
1. To identify the
accomplishments of the national response to TB by reviewing the activities of
the National Programme for TB & Chest Diseases
(NPTCCD), other Government organizations and non-government organizations
especially in areas related to TB prevention and management from last review
conducted in December 2006
2. To evaluate the
progress of implementation of tuberculosis control activities in access to
DOTS and involvement of other sectors in DOTS, quality assurance of
diagnostic services, drug procurement and management, advocacy, communication
and social mobilization, management of multidrug-resistant tuberculosis and
HIV-related tuberculosis interventions
3. To provide
recommendations to further strengthen TB control.
The review team
comprised of experts from International Union for Lung Diseases (UNION),
Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM), Global Drug
Facility (GDF) & World Health Organization (WHO).
The team observed considerable progress in TB
control in the country since the last review in December 2006.
Most importantly they are:
· Active
follow-up on the recommendation of the last review mission.
· Technical support has been utilised to review and revise the recording
and reporting system, to strengthen laboratory and drug procurement practices
and services and initiate implementation of DOTS Plus and the management of
MDR TB with support from the Green Light Committee (GLC);
· Programme guidelines to guide implementation of DOTS Plus, management of
HIV -TB patients and the laboratory network for assuring quality of sputum
microscopy, culture and drug sensitivity testing (DST) are in an advanced
stage of development and will be finalized shortly;
· Greater involvement of the civil societies, other public sectors, private
sector and academia in TB prevention and control activities through GFATM
project;
· Availability of quality drugs
through the Global Drug Facility (GDF). Measures have been taken to
strengthen Procurement Management System relating the TB drugs.
Main recommendations to further strengthen the
National TB response are:
- strengthen TB surveillance, specially expanding the quality laboratory
services and data management system
- early implementation of the DOTS Plus programme in the country to manage
MDR TB
- further strengthen human resource capacity at central as well as district
level
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