In Nepal, the number of cases of tuberculosis (TB) per 100,000 people exceeds 200, and an effort to end the tuberculosis is one of social issues. The Fujifilm Group is contributing to expand the screening opportunities by supporting organizations that promote tuberculosis control.
Basic Data on Nepal
- Population：30.5 million
- Area：147,000km2
- Capital：Kathmandu
- * Quoted from “Basic Data on Nepal,” Ministry of Foreign Affairs of Japan.
Data on TB
Nepal has one of the world's highest rates of tuberculosis in terms of the number of affected people as per population.
- Annual number of affected people：approximately 69,000
- Number of affected people per 100,000 population：229
- * Adapted from the World Health Organization (WHO) GLOBAL TUBERCLUOSIS REPORT 2020.
In a survey conducted in the country, about half of those affected by the disease is estimated undetected. It is an urgent issue to reduce the risk of becoming severely ill and prevent the spread of the disease based on early screening.
Fujifilm Group Initiatives
The Nepalese government has a policy of focusing on Active Case Finding (ACF) to screen people who may have tuberculosis using chest X-rays proactively before they become seriously ill.
In light of these movements, the Japan Anti-Tuberculosis Association (JATA) is promoting the AFC project targeting 8 areas in Kathmandu, the capital of the country, in collaboration with a local NGO, the Japan-Nepal Health and Tuberculosis Research Association (JANTRA), and with support from the Ministry of Foreign Affairs.
Fujifilm Group is providing a compact, lightweight, and easily portable X-ray device and diagnostic supporting software developed using AI technology to this project.
The target areas include low-income neighborhoods, factories, temples, and facilities for the elderly, all of which are considered to be at particularly high risk of being affected with the disease. With the help of staff from the Urban Health Clinic (UHC) and local health volunteers, the project is conducting chest X-rays on 25 to 50 residents per hour/ 150 to 200 people per day. Sputum samples are collected from subjects suspected of having the disease and are tested for bacteria by TB-LAMP and GeneXpert as recommended by WHO.
From July 2022 to August 2023, 15,028 people were screened, and 151 people, 1% of the total, were diagnosed with TB*1. Based on the results, all patients were introduced to the nearest UHC for appropriate treatment.
- *1 Bacteriologically, 47 patients were positive and 104 were negative. More than half of the affected patients had no symptoms.
People waiting for a medical checkup
A health volunteer encourages people on a street corner to take a medical checkup.
A typical Buddhist stupa in Kathmandu is a good place for medical checkups because it is easy to gather people.
Medical checkup site at a temple
Taking X-ray screening
Reading X-ray images
Equipments used for sputum examination
I have been devoting my carrier of a Public Health work in TB control programme to the practice of community-based care and support for last 25 years. The TB problem in developing country is one of the foci in my scope. I have been actively involved in community engagement and TB in hard-to-reach area. In such a way I am deeply concerned with voices of communities affected by TB and their network by linking between community-based actors and NTP. I believe in developing policies, meaningful engagement of civil society organizations is crucial to bring tangible gaps and voices of the affected and infected people screened by chest x-ray in the community base. It can play bridging role to fulfill the health service gaps for TB screening, and for diagnosis and ensuring treatment on time.
I had been engaged in TB control program in urban poor area with the highest TB prevalence rate in Japan in many years. We had used the same ACF with CXR (chest X-ray) for the poor population with remarkable result. Now, I am glad to participate in ACF activities with CXR in the new challenging conditions in Nepal where tuberculosis is gaining prevalence. We hope we could demonstrate a model of ACF in Kathmandu City, soon. I think the key to the successful result is introduction of new technologies and support of community for ACF.
JANTRA has maintained an excellent track record of working in the TB control program in urban and rural areas including hard to reach population, since its establishment in 2008. JANTRA always keep in mind that placing TB patients in the center of the programme and develop the activities base on their information from periphery and grass root level. The delay in TB diagnosis and missing TB cases are the major challenges of the National TB programme. We believe, we have been contributing to reduce delay in TB diagnosis and finding missing cases through active TB case finding with the use of digital chest X-ray and TB LAMP and support to strengthen the Urban TB Control Program in Kathmandu. We are excited and motivated to work on these innovations and efficient interventions in other parts of the country in future.
