Evaluation of a Surveillance System on Multidrug-resistant Tuberculosis in Bangladesh

Abstract

In 2017, the World Health Organization reported that 558,000 people were diagnosed with multidrug-resistant tuberculosis (MDR-TB) or rifampicin-resistant tuberculosis. In Bangladesh, the MDR-TB rate is 1.6% of new cases and 29.0% of previously treated cases. We evaluated the MDR-TB surveillance system to assess its simplicity, timeliness, data quality, stability, flexibility, and usefulness following the guideline of the United States Centers for Disease Control and Prevention. Stakeholders reported that the system was simple and useful for monitoring the program’s performance. However, there was a need to improve the timeliness, data quality and overall coordination between health facilities and the National Tuberculosis Control Program (NTP). Data from all reporting centers did not reach the NTP timely. There were duplication of data and missing demographic characteristics. The surveillance system needs specific objectives, permanent funding and more attention from the government to ensure its stability. A unified electronic data entry mechanism can be achieved using the District Health Information System software in collaboration with the Management Information System of Directorate General of Health Service, Bangladesh National Tuberculosis Program with unique patient identification.

Keywords: multidrug-resistant tuberculosis, National Tuberculosis Control Program, surveillance, Bangladesh, United States Center for Disease Control and Prevention