TB REACH Wave 5: Scale up of Intensified Active Case Find Model in Nepal

The TB REACH Wave 5 project identified and supported through treatment over 1,000 cases of tuberculosis (TB) during its implementation in eight districts of Nepal. By helping these patients to get an early diagnosis, complete treatment and achieve a cure, the project has also stopped further transmission of TB in the community and reduced the consequences of TB disease for the patients and their families.

BNMT worked with the National TB Programme of Nepal, government and community stakeholders to utilise the network of community health volunteers in Nepal for active TB case finding (ACF). Implemented in July 2017 the TB REACH wave 5 project was established in 8 districts with the aim to detect  1,090  additional TB cases, enrol them onto treatment and support then to successfully complete treatment and achieve a cure. In four of these project districts, BNMT partnered with the Nick Simmons Institute to install new GeneXpert machines, advanced technology for the improved  detection of TB cases.

Overall, the project screened more than 38,000 people at high risk for TB, of whom more than 25,000 were symptomatic and 1,092 were diagnosed to have pulmonary tuberculosis. TB REACH has not only been highly beneficial for the earlier diagnosis of TB patients but has created a sense of pride for the committed project volunteers, local health facilities, district health offices and the National Tuberculosis Program in uncovering hidden and inaccessible cases in the fight against TB.

A total of 1092 cases have been found from this project

Some important recommendations of the project include

• use of GeneXpert as the primary diagnostic tool for early case detection,
• development of social protection policy in combination with ACF for mitigating financial burden of TB,
• strengthening of laboratories in microscopy centres for improving the quality of TB testing through microscopy, and
• Longer duration ACF implementation projects to build TB-skilled workforce in hard to reach communities.