ANNUAL HEALTH BULLETIN 2004 - Ministry of Health

TB Control Program in Bhutan is fully integrated with general health care services at the
Dzongkhags since its inception in 1976. Replacement of Long course Chemotherapy (LCC)
by Short Course Chemotherapy (SCC) in a phased manner was initiated in 1988. Learning
from the experience of running the program, recommendations of review mission and
keeping in view, WHO's declaration of TB as a global emergency in 1994, Bhutan adopted
Directly Observed Treatment Short Course Chemotherapy (DOTS) strategy throughout the
country from 1997. At the end of 8FYP i.e within 4 years of implementation of DOTS
strategy, significant progress has been made in the control ofTB in Bhutan.
• To prevent death from TB among poor and vulnerable populations.
• To reduce mortality/morbidity and transmission ofTB until it is no longer a
Public Health Problem.
to intensify advocacy and awareness activities for TB prevention and increased
case detection rates
to improve capacity of health staff to detect and treat TB
to strengthen laboratory capacity to carry out drug sensitivity training and quality
assurance
to strengthen Program management and monitoring and evaluation at district and
national level.
Improving access to DOTS by decentralizing the availability of services and
easily accessible treatment with adequate drugs at all time with specific objective
as under.
• New smear positive case detection of 80% and cure more than 85%
• TB in HIV positive patient diagnosed timely and all such cases are promptly put
on DOTS.
• Multi drug resistant (MDR) does not increase in the country.
• Enhance DOTS utilization by making its accessibility/availability user friendly.
Strengthen diagnostic decentralization and follow up capabilities through
establishment of operational laboratory facilities at BHUs level.