National Tuberculosis Control Program - Egypt






National Tuberculosis Control Program

NTP Egypt

NTP structure
History of TB Control in Egypt
Overview of TB Control Structure

NTP Egypt, Vision, Mission and Strategies

NTP structure



Training Courses of HIO Nurses on TB Control




History of TB Control in Egypt

The Egyptian TB control programme dates back to 1926 when a big hospital was established in Helwan (Helwan sanatorium). This was followed by the establishment of two chest dispensaries in 1930. Gradually a network of chest dispensaries and hospitals was set up all over the country. Patients were usually hospitalized for isolation and after 1945 also for treatment.

An important step towards a more systematic approach was taken in 1979, with the establishment of the National Tuberculosis Control Programme (NTP) in the Ministry of Health (MOH). During this period the emphasis was on BCG vaccination, passive case finding and free of charge supply of treatment for TB patients with standard chemotherapy for duration of 18-24 months.

In its widest sense tuberculosis (TB) control refers to all aspects of health protection, i.e. prevention of tuberculosis and of its complications; early diagnosis; appropriate treatment; patient information and rehabilitation; and, research in different areas related to tuberculosis. Tuberculosis control consists of a variety of activities carried out by different persons in governmental, non-governmental and private organizations and institutions. These activities include immunization (BCG); case finding and treatment; health education; and, surveillance of the disease in the community.

The Netherlands Government has supported the NTP with technical and financial assistance through the Tuberculosis Control Project. This support has made it possible for the NTP to build a firm foundation for effective management of the TB problem.

National Tuberculosis Program (NTP) and Tuberculosis Control Project Egypt (TCPE) started in 1989 by the technical and financial support of the Dutch side.

1st Phase: Started in 1989 and lasted for 5 years till 1994. A complete scientific plan of action for Tuberculosis Control was done and implementation of the program in 10 Governorates was carried out, the funding of this phase was 7 million Dutch Florins.

2nd Phase: Started in 1994 and lasted for 5 years till 1998. Implementation of DOTS strategy was started, the implementation of the program was carried out in 18 Governorates, and the funding was 7 million Dutch Florins.

3rd Phase: Started in 1999 and lasted for 3 years till 2001. During this phase complete coverage of DOTS nation-wide was achieved and the programme covered the 27 Governorates, the funding was 4.5 million Dutch Florins.
Dutch support has been in sustained capacity building which has been reached , to such an extent that in principal routine NTP activities can be carried out independently of outside funding . Support of the Dutch has been ended by December 2001 . It was however been extended ( budget neutral ) , to ensure routine control activities until complete funding for Egyptian side can take place , which can only start at the beginning of the next financial year ( July 2003 )



 Overview of TB Control Structure in Egypt

The Directorate General for Chest Diseases of the Ministry of health was established in 1936 and its network of facilities progressively developed to the current level of 40 Chest hospitals and 118 Chest clinics. The WHO DOTS strategy was implemented from 1996 and became available to all patients in MOHP chest clinics by 2000.
NTP has a three-level organizational structure: Central level - located at the Directorate-General of Chest Disease. intermediate or governorate level, where the Governorate Coordinator for TB (GCT) in addition to the monitoring and evaluation committee represent the cornerstone of TB control activities . The chest facilities and Primary Health Care units (PHCs) represent the peripheral level.
In MOHP, TB care based on DOTS is provided through the network of chest facilities and PHCs. The TB Microscopic laboratory and treatment are available in all chest facilities.
The national reference laboratory (NRL) is actually a Supra-national Reference Laboratory in WHO EMR. There are 18 intermediate TB laboratories supervising TB peripheral laboratories in governorates they cover, and providing culture services. The NRL has started external quality assurance for microscopy in 2006.
The NTP has successfully involved an increasing number of partners in the health sector, either participating in health services provision or in supporting various program activities. Protocols of agreement are signed between the NTP and its partners. These comprise the HIO, the teaching hospitals, and the prisons.
The Health Insurance Organization (HIO) has a TB coordinator in its headquarter and 12 area supervisors. These 12 area supervisors are responsible for routine supervision in their areas.
The NTP has established a successful cooperation with the Prisons health services, and TB cases in the prisons, which represent a high risk group, are currently detected, reported and treated according to NTP guidelines.

The NTP has also started to involve the private sector and operational research has been designed to establish the more suitable approach (Sharqia study)
As regards to collaboration with the voluntary sector, NGOs are considered a strategic partner for reaching the community and raising awareness about TB. The NTP has throughout the years contacted more than 15 NGOs, including the Associations against TB and Lung Diseases, for different purposes.


Vision Statement NTP Egypt

We see the NTP as a data reference source both nationally and internationally as well as developing into a nationally renowned training centre.
Data and training techniques being continuously updated through its international links
To pioneer an international effort of collaboration between similar programmes and by sharing its experience contribute to the elimination of TB as a health problem in developing countries
Expanding our research activities to all fields of TB control and utilizing the results of our research in improving our performance
To develop into a renowned center for national and international conferences




Mission Statement NTP Egypt

To reduce the prevalence of tuberculosis in the community as quick as possible to a level where it ceases to be a public health problem.

This will be achieved through:
- Detecting more than 70% of existing cases of new sputum smear positive tuberculosis
- Curing more than 85% of detected new cases sputum smear positive tuberculosis

We use DOTS as our main strategy together with effective inter-sectoral collaboration
Our Philosophy contains three important elements:
- Patient orientation
- Gender sensitivity
- Sustainability



Related Publications

The Global Plan to Stop TB 2006-2015