Tuberculosis (TB) is an infectious disease that can be fatal if not treated properly. In 2014, 9.6 million people were infected with TB worldwide and 1.5 million died from the disease. Over 95% of TB deaths occur in low- and middle-income countries. The South-East Asia region accounts for a disproportionately high number of global TB cases and Bangladesh is one of 22 ‘high TB-burden’ countries. In 2014, there were 187,005 new cases of TB in Bangladesh and it was the leading cause of death, accounting for 81,000 fatalities. Ending the TB epidemic by 2030 is one of the health targets of the newly adopted Sustainable Development Goals. WHO has set a target for a 95% reduction in deaths and a 90% reduction in TB incidence by 2035. As World Tuberculosis Day marks renewed efforts to ‘Unite to end TB’, we give some insight into the disease that remains a major public health problem for Bangladesh.

TB in Bangladesh

Why are so many people in Bangladesh affected by TB?

Bangladesh has high rates of migration and the transient population faces poverty, overcrowding and poorly ventilated living and working conditions, all of which allow TB to spread. Furthermore, there is a general lack of awareness about TB infection among many parts of the population. Directly Observed Chemotherapy, Short Course (or DOTS) is internationally recognised as an efficient and cost effective way to treat TB and is freely available as part of the Government’s program, however, many people are unaware of this. TB mostly affects adults in their economically productive years, most health facilities are only open in the daytime, so the working population cannot access them easily without taking time off and potentially losing income.

WHO Bangladesh is providing technical support to the Government of Bangladesh as it carries out a Nationwide TB Prevalence Survey to determine the number of cases of TB among those aged 15 years and above. The survey will help to create a comprehensive knowledge base on the burden of disease and ways to improve TB control.

What is being done in Bangladesh to help combat TB?

Bangladesh has a five-year National Strategic Plan for TB Control (2015-2020), which aims to reduce the prevalence of all forms of TB by at least 10% by 2020 and by 5% annually, thereafter. The plan aims to increase annual detection rates of TB and maintain a treatment success rate of at least 90% for all forms of TB. Additionally, the plan supports strategies to help ensure successful treatment of all multi-drug resistant (MDR)-TB cases and strengthen engagement of all public and private health care providers.

What have been the successes in tackling TB in Bangladesh?

The number of TB cases being reported has increased. A treatment success rate of 93% has been achieved among all new and relapsed cases. The multi-drug resistant TB (MDR-TB) treatment success rate is also high at 73%. A greater number of automated diagnostic machines that can determine TB infection from a sample in a short period of time are in use. The National TB Prevalence Survey can also be considered a success in Bangladesh’s fight against TB.

What are the challenges in tackling TB in Bangladesh?

Bangladesh faces challenges in achieving universal access to TB prevention and care services because of poor access to good quality diagnostic services, an inadequate system for screening and lack of sustainable funding for staffing. Lack of engagement of private health practitioners in implementation of the government’s mandatory case notification system is also a problem. Finally, the general public needs to be better informed about TB and its treatment.