Prior to 1993 TB services in Bangladesh were mainly curative and based in 44 TB clinics, 8 segregation hospitals and 4 TB hospitals. During the Second Health and Population Plan (1980-86) TB services were expanded to 124 Upazila health complexes (UHC) under the “Strengthening TB/Leprosy Control Services” project. TB was operationally integrated with leprosy during the Third Health and Population Plan (1986-91) under the “Mycobacterial Disease Control” (MBDC) Directorate. A study conducted by The World Bank in 1990 found low case detection and cure rates at 10% and 40% respectively. Subsequently the NTP adopted the Directly Observed Treatment, Short Course (DOTS) strategy, from November 1993 during the Fourth Population and Health Plan (1992-98) under the project “Further Development of TB and Leprosy Control Services”. NTP started its field implementation in November 1993 in four pilot Thanas (later renamed Upazilas) and progressively expanded to cover all 460 Upazilas by June 1998.


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