DIFFICULTIES IN IMPLEMENTATION OF TB PROGRAMME
・Tuberculosis is the "neglected" disease
・Permanent shortage of budget
・Working condition is "bad":
Since the medical staff should work with infectious, "neglected" patients, young personnel do not like to work in such conditions
・High staff turnover: For instance: 75 laboratory technicians from 31 units are trained in 1994-1999; 40.3% of laboratory technicians a year leave their job.
・Negligence to the health education
Achievements of NTC
1. Integration of the TB and primary medical care organizations:
TB now is detected at the family and soum doctor's level
2. International standards of TB diagnosis:
Network of 31 TB diagnostic and reference laboratories has been established, bacteriological confirmation of diagnosis has been increased from 8.6% to 68.1% (Objective is 70%)
3. Quality control system:
Analysis made in the local laboratories are certified. Disagreements in diagnosis are 0.4% for false positive and 1.6% for false negative (Internationally accepted level is <5%).
4. TB treatment standards:
Implementation of DOTS allowed to increase TB cure rate from 31.9% to 81.9%.
(World average is around 58%).
5. Registration and reporting system:
Implemented according to the international standards; the new monitoring system is in place
6. Supervision
NTP Supervision unit has been set up; implementation of NTP in local areas is improved (300 Supervision missions worked 721 days in countryside during 1994-1999).
7. Manual on TB control:
8 manuals on TB control for different professionals are developed and used nationwide.
8. Software on TB control is under implementation:
Joint "CARMADON" system of NTC, Mongolia; Logos, Russia; and Barclay, USA.
9. IUATLD Collaboration Centre
