TB treatment provision in Bangladesh

There is a lack of general knowledge among the most vulnerable population in Bangladesh about TB, its symptoms, treatment and where to seek help. A number of information campaigns are carried out by LEPRA Health in Action in markets, schools and other public places to inform the general population about this disease.

Treatment for TB has an 85% success rate, unfortunately only 44% of cases are detected. This results in a large number of people spreading the disease. LEPRA organises community activities to provide free TB testing with the help of local volunteers. These activities are aimed at people in remote villages who are at risk of TB infection.

LEPRA uses the World Health Organization recommended strategy for detection and cure of TB also known as Directly Observed Treatment, Short Course (DOTS).

DOTS produces cure rates of up to 95 percent even in the poorest countries and has been labelled by the World Bank as “most cost-effective of all health interventions.”

Multi-drug resistant TB can develop during the treatment for TB when pateints fail to complete a course of treatment. DOTS ensures that patents continue taking their TB medication. This is important in ensuring that drug resistance does not occur. 

Patients with infectious TB (where bacilli are visible in a sputum smear) are first identified using microscopy services.  Thereafter health and community workers and trained volunteers observe and record patients taking the full course of the correct dosage of anti-TB medicines over a number of months. 

The sputum smear test is repeated after two months, to check the patient’s progress, and again at the end of treatment. A recording and reporting system documents patients’ progress throughout, and the final outcome of treatment.

A key component of the DOTS strategy is to reach as many people as possible with information. The population density of Bangladesh is very high and 70% of health providers are private. Thus local people are being encouraged and trained to become health educators  and DOTS providers. In this way they can reach out to their communities and access to health is improved.