Save the Children
Save the Children is the world’s leading independent children’s right organization with members in 30 countries and programs in more than 120 countries. Save the Children fights for children’s rights and delivers lasting improvements to children’s lives in Bhutan, Nepal and around the world. Save the Children has been working in Nepal since 1976 focusing on programs on Child Rights, Governance and Protection, Education, Health and Nutrition, Livelihood and Humanitarian response and preparedness in all 75 districts of the country through four regional offices in Biratnagar, Kathmandu, Butwal and Nepalgunj. Through its various programs, Save the Children aims to create an environment which enables a child to reach his/ her full potential.
Global Fund programs of Save the Children in brief Save the Children is the Principal Recipient for all three Global Fund grants (HIV, Malaria and Tuberculosis) in Nepal since 16 July 2015. Save the Children has been managing the HIV component of Global Fund grant in Nepal since 16 November 2008. Effective from 16 July 2015, Save the Children has been awarded with the PRship for Malaria and Tuberculosis grant as well to be implemented through Epidemiology and Disease Control Division (EDCD) and National Tuberculosis Center (NTC) under the Ministry of Health, Nepal respectively, as main implementing agencies. Tuberculosis grant effective from 16 July 2015, Save the Children has been managing Tuberculosis program all over the country through main implementing agency (NTC). Save the Children works together with National Tuberculsosi Cencte and its sub recipients; Nepal Anti-Tuberculosis Association (NATA), TB Nepal, NAPID Nepal, HERD and BNMT. Major activities under Tuberculosis grant are: National TB Prevalence Survey, early diagnosis of people with infectious pulmonary TB by sputum smear examination, strengthening network of microscopic centers, strengthen quality control measures, treatment of MDR and XDR cases, strengthening culture and drug susceptibility tests (DST), expansion of microscopic camps in hard to reach areas, etc. The key activities of SRs are contract tracing, transportation of sputum transportation, diagnosis and management of childhood TB, Public Private Management (PPM), implementation of IPT, etc.
The total budget of the Global Fund for tuberculosis for FY 2016/17 is 6.4 million USD. A Programme Management Unit is based at National Tuberculosis Centre, Bhaktapur to provide technical support, implement GF funded activities and system strengthens of NTC. SCI is supporting to implement and monitoring and evaluation of Tuberculosis Programme at regional and district level. A Regional Program Coordinator is deputed in each region to support to implement, supervise and monitor TB program at regional and district level.
World Health Organization
World Health organization (WHO) has been supporting TB program in Nepal. The Center of Disease Control unit at WHO CO, headed by the International Medical officer and supported by National professional officers, supports TB program in the country. The main role of WHO is to provide best practices and recommend them to NTP, PR and partners for timely and effective management of different key activities. Recently TB program has been made a top priority from SEARO for Nepal.WHO supports TB program specially by providing technical support in key strategic areas and as required by NTP. Recently, there had been TA support for PMDT revision, introduction of shorter regimen, a DSM development. The mission also supported in development of newer clinical treatment and diagnostic algorithm for the country in alignment with 2017 WHO revised recommendations for Treatment and 2016 GLI recommendation for Diagnosis. WHO also supported in development of laboratory strategic plan and support in development of National Strategic Plan for TB program 2016-21. WHO also supported in carrying out the GLC missions in the country
Besides these key TA supports, WHO also supported in development of major documents like annual reports, TB HIV collaboration guidelines, training guidelines etc. WHO has also supported in carrying out prevalence survey for TB in the country; from the development of the protocol together with RIT japan and NTC followed by reviewing the developed protocol for Global Task Force at WHO HQ and also taken up the responsibility to quality assure the field implementation of PS in the country.
SAARC Tuberculosis and HIV/AIDS Centre (STAC)
SAARC TB and HIV/AIDS Centre (STAC) is one of the Regional Centers of South Asian Association for Regional Cooperation (SAARC), which was established in 1992 as SAARC Tuberculosis Centre (STC) and started functioning from 1994. The Centre supports the National TB Control Programmes (NTPs) and National HIV//AIDS Control Programme (NACPs) of the SAARC Member States (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka). The Centre coordinates the progress and new findings of NTPs and NACPs among the SAARC Members States and supports for implementation of SAARC Regional Strategies on controlling /elimination of tuberculosis as well as prevention of HIV/AIDS in the Region.
Summary of Key achievements made in 2017
A Meeting of the Programme Managers and Cross Border Issues on TB and HIV/AIDS Control Programmes was organized in Bhutan with the objectives of the meeting were to share the achievements, experiences and innovations on TB and HIV/AIDS by the SAARC Member States and learn from best practices and to identify the regional activities of STAC according to felt the needs of the region.
SAARC TB and HIV/AIDS Centre (STAC), Nepal and Central Tuberculosis Division, Government of India jointly organized a SAARC Regional Training on Operational Research on TB and HIV/AIDS at Indian Institute of Health Management Research (IIHMR), Jaipur, India with the Objectives; to increase the capacity of program manager of TB and HIV/AIDS and relevant staff of member countries on concept, approaches and methodologies of operational research, to identify the priority research areas on TB and HIV/AIDS, to build capacities of the participants in planning, designing and conducting operational research.
SAARC Regional Training on TB for Microbiologist on Culture & DST, Gene Xpert/CBNAAT and its Maintenance with the objectives – to improve the capacity of the NRLs for Culture & DST services under National TB Control Programme as well as be capable to participate in surveillance activities and to produce trainers to train the personnel on Culture, DST & Gene-Xpert(NAAT) of M. tuberculosis and their maintenance. New Delhi, India
The STAC also organized the SAARC Regional Training of Trainers (ToT) on Diagnosis, Treatment and Programmatic Management of Pediatric TB in Colombo, Sri Lanka with the objectives to strengthen participants’ capacity in the clinical management of Pediatric TB and to discuss and share experiences of clinical management, challenges to be faced in diagnosing & treating of childhood TB. Similarly the SAARC Regional Training on Management Information for Action (MIFA) for Tuberculosis & HIV/AIDS Control Programmes New Delhi, India. The objectives of the training were to provide knowledge and skills on management information for action with focus on TB and HIV/AIDS control programs, to strengthen the skills of participants in data entry and analysis using analytical Soft ware Programmes and to assist Member States in review of their TB and HIV/AIDS control programmes
The centre also carried out the SAARC Exposure visit to observe the best practices on HIV/AIDS in Nepal. The experts from SAARC Member States observed the activities being carried out by National HIV/AIDS Control programmes and made field visit in different service centres in the Kathmandu Valley.
LHL International Tuberculosis Foundation, Norway
LHLI has been supporting to the NTP in Nepal especially focusing on capacity building by training and supervision activities at various levels since 1995.
LHLI supports NTP in the following areas:
- Training/orientation programs to health workers and community people, development and printing of IEC materials.
- Supporting the technical assistance for the national prevalence survey and other survey
- Arrangement for the annual visit of the technical experts to review the progress and challenges of NTP
- Implementing skill development training for MDR patients
- Financial support to implement community DOTS program
The LHLI supported to implement following major activities of NTP in 2017:
- Skill Development Training To DRTB Patient: This is one of the major activities that has visible impact to have good result in treatment compliance and outcome of DR patients as well as establishing them in society with a skill that supports their livelihood in their life. This year skill development training was conducted for 10 DRTB patients through NATA, Morang on driving, mobile repairment, and sewing and cutting.
- Printing Of Tb Booklets for Tb Patients And Clinical Manuals: 700 TB booklets and 650 clinical manuals printed and distributed in the districts
- Support to Implement Prevalence Survey: The Research Institute of Tuberculosis (RIT), Japan has continuously been provided technical supports to TB Prevalence Survey in Nepal. LHLI has been covering technical assistance of RIT.
- Support to Organize Technical Advisory Group (Tag) Meeting: HLI Supported to organise this meeting to facilitate the discussion on shorter regimen and Programmatic Management of Drug Resistance TB programme, training guideline and manuals
- Tb Patient Satisfaction Survey: The major finding of the surveys were;
- The major findings from the quantitative study revealed that nearly half of the patients had pulmonary positive TB. It was found that two third of patients had spent Rs.1000-20000 before diagnosis of TB.
- The percentage of open discussion with healthcare providers was higher for male (65.3%) as compared to female (34.7%). Male patients (65.5%) perceived the services to be more patient friendly than female patients (34.5%).
- It was also found that most of the patients visited health facility for 1 to 5 days before diagnosis of TB.
- Majority (77%) of the patients were averagely satisfied with structure while receiving TB services, where most of them were female and temporary employed individuals.
- Patients were getting a lot of help from the skilled development training along with healthy foods and transportation costs during their treatment provided by the program.
The approved NTP support budget for 2016 was NPR 5.6 million, of which NPR 5.6 million was spent (100%) budget during January to December 2017.
Japan-Nepal Health & Tuberculosis Research Association (JANTRA)
Japan-Nepal Health and Tuberculosis Research Association (JANTRA) is a non-profitable and non-governmental organization affiliated with the Research Institute of Tuberculosis/Japan Anti-Tuberculosis Association (RIT/JATA), Japan. Since its establishment, it has maintained an excellent track record of working on a TB control program in urban and rural areas including hard to-reach population. It has successfully completed different TB projects such as the Global Fund in the Central and Western Region, a TB Reach project in Kathmandu valley, Post disaster TB project and prevalence of TB/diabetes co-morbidity survey in Kathmandu valley. JANTRA is an active and trusted partner of the National Tuberculosis Program (NTP).
Franchise to promote health and prevent from health problems through the application of evidence based public health practices, quality health services and research in Nepal.
Key activities performed in 2073/74
Urban TB-Control program
The program has been implemented in partnership with RIT/JATA in Kathmandu Valley since 2008 delivering quality and patient friendly TB diagnosis and treatment services.
Post Disaster Recovery Support Project in Kathmandu Valley
Post disaster recovery support project has been implemented in partnership with RIT/JATA in Kathmandu Valley since 2016 providing psychosocial and nutritional support to the patients.
TB-DM comorbidity Survey
The study on relapse of tuberculosis among diabetes patients in Kathmandu is being carried out in association with the National Center for Global Health and Medicine (NCGM), Tokyo, Japan.
Women’s Health Project
JANTRA is executing Women’s Health Project (WHP) as a local implementing partner of Population Service International/Nepal since 2017 with the aim to increase access and use of Long Acting Reversible Contraceptives (LARC) particularly Intra Uterine Contraceptive Device (IUCD) and increase access to safe medical abortion services.
Birat Nepal Medical Trust Nepal
Birat Nepal Medical Trust (BNMT Nepal) is a Nepalese non-governmental organization dedicated towards the improved health and well-being of Nepalese people. Since its inception 1967, BNMT Nepal continues to support the Government’s interventions on tuberculosis, mental health, child health, maternal health and to combat HIV/AIDS and other diseases.
Major Interventions and Achievement
National Tuberculosis Program
BNMT Nepal has been implementing ‘National Tuberculosis Program’ from January 2017. The project is funded by Global Fund and the Primary Recipient (PR) of the project is Save the Children International. BNMT Nepal is working as a Sub Recipient (SR) in order to contribute and support the National Strategic plan 2016 to 2021.The project’s Goal and objectives are set to contribute and support to achieve the National Strategic Plan (2016-2021).
TB Case Detection and Prevention
- 225 DOTS centers (terai districts) and 593 DOTS center (hill districts) were linked in Courier system in hard to reach areas.
- In mandatory contact tracing, 27,445 family contacts were screened and 245 TB cases were detected.
- 399 children under the age of 5 years are under Isoniazid Preventive Therapy.
- For presumptive DR TB cases, 931 DOTS Centers were linked to Microscopic Centers in courier system, 387 presumptive DR TB cases were screened and 18 DR TB cases were diagnosed.
- 517 family member contacts of DR TB were screened and 3 DR TB cases were detected.
- Child screening from malnourished/ARI cases were 42519, out of which 2024 presumptive childhood TB cases were identified, 1483 presumptive TB cases were referred to health institution for TB diagnosis and 59 childhood TB cases were diagnosis on the basis of x-ray, Montoux test clinical basis.
- 31 MC centers were provided support for strengthening of infection control measures during the period.
- 41 TB cases were notified from private health institution through E-TB reporting system.
- 254 events were organized to orient the school children, 16 events for Health teachers on TB.
- There were 27 events organized for strengthening cross referral mechanism of TB/HIV and 656 health workers participated in the orientation training.
IMPACT TB Project
BNMT is implementing IMPACT TB (Implementing proven community based case finding intervention in Nepal) project from 1 January, 2017 to 31 Dec, 2019.
TB REACH Wave 5 Project
Birat Nepal Medical Trust has been implementing the TB REACH project since 16 March 2017. Activities under TB REACH Wave 5 project are :
- Contact tracing
- Referral of TB suspects to mobile camps
- Case refer and testing with Gene Xpert
Management of the Eastern Region TB Quality Control Centre
BNMT Nepal manages the Eastern Region Quality Control Centre (ERQCC) by working in close coordination with the Ministry of Health of Nepal in quality control in the Eastern Region. BNMT Nepal is responsible for providing the human resources as well as the Quality Assurance of TB Microscopy and the Government of Nepal is responsible for overall guidance, monitoring and supply of logistics for this purpose.
Health Research and Social Development Forum (HERD)
Health Research and Social Development Forum (HERD), established in 2004, is a national non-governmental organization with an aim to promote quality of life of people, especially women and children, the poor and the disadvantaged communities. HERD works across the nation in terms of 3 components: research, survey, monitoring and evaluation; health systems delivery; and policy development adopting a system approach driven by equity, needs and priorities of the country, in line with the global framework. We develop, test and deliver evidence-based, feasible, and cost-effective interventions relating to health and social development.
HERD Focus on Tuberculosis
Tuberculosis has been one of the priority service components of the organization since its inception. HERD has provided technical support, policy formulation and conducted research activities to support NTP. HERD was sub recipient of the Global Fund Round-7 and NSA grants (Phase I and Phase II). In the FY 2072-73 HERD in collaboration with NTP, implemented the TB reach project in 29 municipalities/ urban areas of 22 districts of Nepal through an innovative strategy to reach the unreached high-risk population and provide TB services to them using a mobile van with embedded diagnostic services. In this fiscal year HERD implemented “Support to implement the National Tuberculosis Program in partnership with Save the Children International (SCI) and collaboration with National TB center” in 21 districts of central and western region from January 2017 – March 2018.
Beside this HERD focused on two important TB research activities: 1) Improving the supervision and patient support for drug resistant TB patients in Nepal 2) Tobacco cessation intervention to TB patients (a multi country study).
HERD also provided technical support in finalization of the 5 years plan of NTP, NSP 2015-2021. In concept with Public Private Mix, HERD has also been providing diagnostic services through Gene X-pert test. It has its own laboratory setup for GeneXpert.
Key Activities and Achievements in FY 2073-74
The key program component addressed were sputum courier, contact tracing, management of childhood tuberculosis, Drug –Resistant Tuberculosis management, Public- Private Mix along with various capacity development events to the health workers. 44 PBC cases were identified during this period. The program was further given continuity for fiscal year 2074-75 with expected increase in case detection. For Gene X-pert testing the patients are referred for testing from various public and private hospitals of Kathmandu valley. In this fiscal year among 2404 sample tested 264 sample showed MTB detected Rifampicin Sensitive, 63 sample showed MTB detected Rifampicin Resistant, 22 sample showed invalid error and in 2055 sample there was no MTB detection. The organization continues to work closely with NTC/NTP in accomplishing the vision of TB free Nepal in days to come.
National Partnership for Integrated Development Nepal
National Partnership for Integrated Development-Nepal (NAPID-Nepal) established in 2006 A.D. is a nonprofit service based, non-governmental organization working in the field of health and human right in Far-western region of Nepal. Since 2011 NAPID-Nepal has been implementing regional level Drug Resistant (DR-TB) Hostel, treatment service, TB/HIV awareness and advocacy program in joint collaboration with National Tuberculosis center Thimi Bhaktapur. From this F/Y 2016/017, NAPID Nepal has been working for national tuberculosis program funding from Global Fund as a sub Recipient (SR) and implementing DR TB hostel program in Dhangadhi, Kailali.
- Establishment and operation of DR-TB hostel in Dhangadhi, Kailali and provide food, shelter and treatment to DR-TB and TB-HIV co infected Patients.
- Sputum collection and courier to Genetop, Kathmandu for culture and DST through SZH.
- Regular laboratory investigation of MDR-TB patients: – potassium, creatinine, LFT, TSH etc through SZH.
- Counseling to MDR-TB patients, their families and community.
- Treatment of DR-TB patients.
- Side effect management of DR-TB patients.
- TB /HIV awareness and advocacy.
Nepal Anti tuberculosis Association
NATA is a non-governmental, non-profit making voluntary organization established in 1953 with a view to raise public awareness about Tuberculosis (TB) by adopting preventive and curative measures towards the control of the tuberculosis. NATA has long standing history of collaboration with National Tuberculosis Program (NTP) as one of the oldest and key partners. It has branches in 38 different districts of Nepal and has been expanding its activities for the prevention and control of TB through health education program and curative services since its establishment.
Activities/Services provided by NATA
- German Nepal Tuberculosis Project (National Reference Laboratory)
- Kalimati Chest Hospital (One and only chest hospital of Nepal)
- DOTS service
- Drug Resistance (DR) TB management services
- DR hostel
- Culture, DST and other laboratory services
- X-Ray Services
- HIV counseling and testing service
- Advocacy, Communication and Social Mobilization (ACSM) activities
- Research and surveillance
National Tuberculosis Day
NATA has been celebrating its Establishment Day as National Tuberculosis Day each year on Mangsir 13. Week long program was organized by NATA to celebrate 63rd National Tuberculosis Day. Where orientation to volunteers (42 TB patients and 45 Non DR TB), Blood Donation camp, School level Orientation, Drama performance by 10 Patients admitted at Kalimati Chest Hospital was done. Participants were rewarded with letter of appreciation, prizes. On the same occasion fruits and nutritional diet was distributed to the patients at DR Hostel, DOTS Clinic and Kalimati Chest Hospital.
World Tuberculosis Day
NATA celebrated the 135th world TB Day on 24th March 2017 through raising awareness against TB. 40 volunteers disseminated information about tuberculosis by door to door visit and leaflets distribution approach. To strengthen the immunity suppressed by the infection, NATA with the support from International Organization for Migration (IOM) commenced to provide fruits and nutrients to patients at DR TB patients
Health Camp/TB Screening
In coordination with Yang-Min University of Taiwan, NATA has conducted tuberculosis screening program at Phuntsok Choling Monastry and Saint Joseph School. Among them 11 monks were found to be positive that were later referred to NATA. Likewise TB screening was done at St Joseph School, where 184 students were screened using Mantoux test. None of the students were found to be TB positive. For those Monks who were found to be positive they were suggested to visit NATA for further investigation and to initiate the treatment.
TB Nepal is a non-governmental organization founded in 2060 BS (2003 AD). The goal of the organization is Sustainable improvement in health & quality of life of poor and marginalized TB, Leprosy and HIV affected people in MWR.
TB Nepal began treating TB patients in the Mid-western region (MWR) of Nepal since 2003 (2060 BS) as a DOTS and sputum microscopy centre. Nepalgunj TB Referral center Banke is the center for the diagnosis and treatment of complicated TB cases with 24 hours in-patients care facility.
TB Nepal situated in the center of Nepalgunj sub-metropolitan city, ward No 4 is fast growing sub-metropolitan city and close to the Indian boarder. TB Referral Center Nepalgunj provides services mainly to the people of the Bheri, Rapti , Karnali zone and to the people from other region and from the border side of India. TB Nepal provides services to large number of people affected from Tuberculosis.
Nepalgunj TB Referral Centre (NTRC) has 2 separate (TB and Leprosy) OPD services. TB suspect and TB patients who come for TB investigation, follow-up visit and complication management is done at NTRC. 30042 patients visited (Male 18992 and 11050 female) in OPD in this year 2073 / 074.
MDR TB Service.
Nepalgunj TB Referral Center (NTRC) is one of the DOTS (Directly Observed Treatment Short course) centers of the mid-west region. The center provides daily DOTS to first line TB patients and second line TB (MDR TB treatment) service to Multi-drug resistant TB patients. 37 new MDR and 24 Pre XDR TB cases were registered in the year 2073 / 2074 .Now 53 MDR TB patients are taking second line TB treatment from various center and sub- centre of the region. DR TB treatment success rate is 77 %.
Nepalgunj TB referral Center has in-patient service with 29 beds for TB where care is provided to seriously ill TB patients who require in-patient care and who can not access such care at other place. In-patient service is available 24 hour every day. Patients with extensive lung involvement, TB meningitis, spinal TB, MDR TB, TB patients with HIV/ AIDS Co-infection, side effect of drugs and its reaction and seriously ill TB suspects benefits in in-patient service. Patient’s recreation, Counseling, advocacy and health education services are also provided to In-patients and their families. Nutritious Food and accommodation is provided free of cost. 589 TB patients were admitted in 2073 / 2074 (2016 / 017 AD). Bed occupancy rate was 83 % and average length of stay was 11 days at TB side. Of 589 admitted TB patients, 554 are discharged, 16 were referred to other hospitals, and 9 died.
Nepalgunj TB Center has a well-equipped laboratory where necessary investigations are performed for the diagnosis of TB. There is very good network with national reference laboratory for Sputum culture and drug sensitivity test. In this year 667 sputum samples was sent to genetup Kathmandu for culture & sensitivity test. Sputum smears test 11332, HIV test 965, Mantoux test 704 and near about 18000 basic blood tests was done in the Laboratory in this year. Four monthly quality control reports were found excellent according to Government Quality control Laboratory.
Skill transfer Activities
TB Nepal has provision of skill transfer activities about TB and leprosy treatment to the BHS (Basic Health Service) staffs of government of Nepal, other suitable partner NGO staffs, independent individuals who recently passed their course. 40 Health Assistant and 80 nursing students were benefited by exposure to the clinic in 2073 /2074. 1 ANM, 2 staff nurse and 3 CMA were completed their 3 months course. In this period 3 lab assistant came for TB sputum smear and leprosy skin smear training. Onsight coaching to various health facility staff during supervisory visit for TB management.
Charity / poor fund
TB Referral Center has Charity /Poor fund and have provision of financial assistance to poor and needy patients. Near about 9464 patients have been benefited from this Charity/Poor Fund in year 2073 /2074 through medicine charity, investigation charity, support in transportation fare and food and accommodation. Charity is given on the completion of socio-economic assessment form of the patients and their families. Food and accommodation are free for all admitted patients.
Beside the regular services, the center was actively involved in awareness raising activities in World Tuberculosis Day, Leprosy Day and HIV/AIDS day in coordination with the District public Health Office Banke.
Monitoring and Evaluation
Time to time supervisory visit is conducted by DTLO, RTLO and NTC and Save the children / Global Fund. The Nepalgunj TB Referral center has up to date record of TB and Leprosy clients and activities. This center also supervises and monitors MDR TB activities in the 8 MDR TB sub-centers of the various part of Mid-western region. This is the only DOTS & MDR TB center in the region where services are available in outpatients and in-patient basis. Nepalgunj TB Referral Centre has its own internal monitoring and evaluation of the center activities by internal staff (taking interviews with patients and recorded by an independent outsider/patients satisfaction survey etc) on monthly, four monthly and yearly. TB Nepal actively involved in regional base TB / leprosy related supervision and training.
Introduction of IOM:
Established in 1951, The International Organization for Migration (IOM) is the leading inter-governmental organization in the field of migration and works closely with governmental, intergovernmental and non-governmental partners. With 169 member states, a further 8 states holding observer status and 393 offices in over 100 countries, IOM is dedicated to promoting humane and orderly migration for the benefit of all.
IOM started its operations in Nepal in 2007 facilitating the resettlement of Bhutanese refugees to various eight destination countries. Since then, IOM has expanded significantly both in terms of programme areas, target populations and has contributed to the government of Nepal’s efforts to manage migration more effectively through a wide range of programmes including Migration and Health. IOM believes that migrants and mobile populations benefit from an improved standard of physical, mental, and social wellbeing, which enables them to substantially contribute towards the social and economic development of their home communities and host societies. IOM Migration Health Division (MHD) provides specialised health screening service for Migration and Health. Through the MHD, the IOM conducts health assessments of Bhutanese refugees and immigrants bound to USA, UK, Australia Canada and New Zealand. Diagnosis and treatment of TB have been the main focus of health assessments of refugees and immigrants. Over 150,000 refugees and 60,000 immigrants have been screened for TB since 2007. Health assessment and TB screening and treatment service is provided through the operation of clinics in Kathmandu and in Damak. Furthermore, IOM has successfully implemented TB related projects such as TB REACH Project and TB harmonization project in the past.
Activities and achievements:
This year, IOM continued to screen immigrants and refugees for TB. A total of 4,978 refugees were screened for TB. Of them 720 (14.465) refugees were tested for TB as their chest x-ray was found to be abnormal and 67 (9.3%) were detected of having TB, 62 (92.53%) were enrolled in the TB treatment and 59 (95%) were cured for TB. Likewise, total 12,691 immigrants were screened this year, of them, 553 presumptive TB were identified and tested for TB, 46 were detected of having TB and they were all treated at IOM DOTS clinic and cured completely (100%).
IOM Nepal also handed over the TB REACH project to National TB Centre this year. IOM installed 10 GeneXpert machines and trained NTP laboratories staff on testing and reporting through the TB REACH project. The project was implemented from the year 2012 to 2016. Over 50,000 test were performed resulting into detection of 10,000 MTB cases including 550 Rifampicin resistant cases in the project. Many lesson learned and best practices regarding the operation of GeneXpert technology and active case finding were also shared with NTP and other stakeholders.