Tuberculosis Burden in Bangladesh: Progressions and Challenges of Continuing Control Intervention

Abstract

Tuberculosis (TB) has been a significant public health burden in Bangladesh, and to address this issue, the country has implemented the Directly Observed Treatment Short-Course (DOTS) intervention since 1993. The government has partnered with non-governmental organizations (NGOs) to implement community-based TB control programs. Research has shown that this approach has led to significant success in TB control, including a high case detection rate (> 81%), successful TB treatment (95%), and reduced TB mortality (27/100,000 population) over the past two decades. However, there are still significant concerns regarding the control of people living with HIV-TB (PLHIV-TB), multidrug-resistant TB (MDR-TB), and latent TB infection (LTBI). Additionally, the COVID-19 pandemic has slowed down the progress of TB control efforts. Challenges such as inadequate linkages with local NGOs, social stigma, gender discrimination in TB diagnosis, inadequate human resources, and poverty factors further exacerbate the situation. This study calls for a paradigm shift in TB control intervention towards a rights-based and need-based approach, considering gender, ethnicity, elderly people, and children. By addressing these challenges and implementing a comprehensive approach to TB control, Bangladesh is expected to achieve its goal of ending TB by 2035.