The National TB prevalence survey 2018-19 was the first ever nationally representative TB survey to understand the actual TB disease burden in the general population in Nepal. The survey also measured the health-care seeking behaviour and service utilization among survey participants. The survey estimated the prevalence of TB in Nepal based on the direct survey findings of bacteriologically confirmed pulmonary tuberculosis among ≥ 15 years population in Nepal.
Field data collection was carried out in 99 cluster sites. 92% of eligible population participated in the survey. Individual interview to screen symptom and Chest X-ray by direct digital image were offered to every participant and 96.8% of participants received Chest X-ray. Of the 28% who were eligible for sputum, 98.6% submitted at least one sample. Xpert MTB/RIF was used as the primary diagnostic tool for all sputum eligible participants and culture was done for 50% of the participants eligible for sputum and among those with a history of TB. 99% of those who submitted sputum had at least one valid result of Xpert MTB/RIF. 225 cases were directly identified as PS case.
According to the survey, currently over 117 000 people are living with TB disease in Nepal. Likewise, 69 000 people developed TB in 2018-19. TB burden (incidence) is much more higher (1.6 times) than previously estimated. TB prevalence is much higher among elderly and in men. TB prevalence was also found more in hills and terai as compared mountain and KTM valley, but prevalence/notification ratio (P/N ratio) highest in hill and mountain. These findings provide better burden estimates for Nepal which will be used for designing appropriate interventions towards ending TB in Nepal.