Situation Update
Tuberculosis (TB) continues to be a major public health challenge in Afghanistan. Medicines and diagnostics are made available free of charge in the country. In 2016, an estimated 65,000 cases and 11,000 deaths were caused by TB in Afghanistan. In 2017, 47,406 cases were detected and enrolled on treatment. Out of all health facilities (2,857), 71% are providing Directly Observed Treatment (DOTS) services.
In 2017, a total of 392,272 presumptive cases were tested for TB. Among the new cases:
19,479 (41.1%) were bacteriologically confirmed
13,029 (27.5%) were clinically diagnosed
12,329 (26%) were extra pulmonary cases
A total of 9,732 (20.5%) TB cases were children, and 56% of all cases were women. Of all TB-diagnosed patients, 70.6% were in the productive age group (15–64 years), and 52.3% of women were in the reproductive age group (15–44 years). Contact tracing was conducted for 84% of respiratory symptomatic cases; 22,939 children (93% of contacts) were put on isoniazid preventive therapy (IPT).
A total of 22,591 (47.6%) TB cases were screened for HIV; 7 cases (0.05%) reported TB/HIV co-infection. Additionally, 201 multidrug-resistant TB (MDR-TB) cases were diagnosed and enrolled for management. The treatment success rate for all cases in 2016 was 89.2%.
Achievements
Ensured uninterrupted supply of TB medicines and laboratory consumables worth USD 3.6 million.
Provided ancillary drugs for management of adverse drug reactions.
Trained nearly 960 health staff on TB drug management and facilitated 196 mentoring visits by NTP staff (2015–2017).
Developed and revised technical guidelines and standard operating procedures.
Mobilized a two-year grant from the Global Drug Facility (GDF) to treat 9,861 cases using new TB pediatric formulations (2016–2017).
Mobilized USD 8.6 million from the Government of Japan/JICA to support 50% of FLDs and 60% of SLDs for 2018–2020.
Facilitated mobilization of USD 10.6 million from the Global Fund for 2018–2020.
Renovated TB Central Drug Stores in Kabul, as well as storage facilities at NTP, Afghan-Japan Communicable Disease Hospital, and provincial TB stores.
Programme Risks and Challenges
Cultural barriers and stigma around TB.
Deteriorating security situation affecting access to services.
Inadequate human resources capacity at health facilities and lack of quality assurance in laboratory services.
Way Forward
Partnership development and resource mobilization.
Scale up pharmacovigilance of anti-TB medicines.
Promote innovations to improve case detection.
Strengthen the management of childhood TB and Programme Management of Drug-Resistant TB (PMDT).
Build the capacity of NTP staff to conduct implementation science research.
Scale up management of multidrug-resistant TB.
Strengthen TB/HIV collaborative activities.
Related Links
Evaluation of Programme Management of Drug Resistance TB
Annex 1: Sample Transportation Plan
Annex 2: National Strategic Plan for Tuberculosis Control 2017–2021
