The Bhutanese Leading the way.
Bhutan continues to maintain a treatment success rate of more than 90 percent among tuberculosis (TB) patients, but identifying all TB cases remains a key challenge for the National Tuberculosis Control Program.
Phurpa Tenzin, Senior Program Officer with the National Tuberculosis Control Program, said the decline in TB case detection rate does not reflect problems with treatment outcomes but highlights the gap between estimated TB cases and those being notified.
“The decline in the case detection rate from 78 percent in 2017 to 63 percent in 2023 is primarily attributed to a reduction in TB case notifications against the WHO estimated cases for each year and does not indicate challenges in treatment success rate,” he said.
He said the priority now is to strengthen case finding, early diagnosis and timely treatment to identify people with TB who remain undiagnosed.
“Therefore, the key priority remains strengthening TB case finding, early diagnosis and treatment to close the gap between estimated TB incidence and notified cases,” he said.
To improve early detection, Bhutan has expanded the use of rapid molecular diagnostic tools such as GeneXpert MTB/RIF, which can detect TB and identify drug resistance at the time of diagnosis. The country currently has 18 GeneXpert sites, including one mobile van, with 21 machines placed across strategic locations.
The program is also using artificial intelligence-supported computer-aided diagnostics along with digital X-rays to strengthen screening and detection.
For drug-resistant tuberculosis (DR-TB), Bhutan provides free diagnosis, treatment and follow-up care through the National Tuberculosis Control Program. Newer medicines, including bedaquiline, have allowed eligible patients to receive a shorter six-month treatment regimen compared to earlier treatments that could last nine to 18 months.
The program has also shifted towards more patient-centered care, with ambulatory treatment preferred over prolonged hospital stays, allowing patients to receive care and support while staying at home.
Phurpa Tenzin said household and close contacts of DR-TB patients are systematically screened, while eligible contacts are provided preventive treatment to reduce further transmission.
Meanwhile, the Health Minister advised the public to seek medical care if they experience symptoms of tuberculosis, including a persistent cough lasting more than two weeks, fever, night sweats, unexplained weight loss, fatigue, or coughing up blood, to ensure early detection and timely treatment.
