KATHMANDU, March 25: Tuberculosis (TB) continues to pose a serious threat in Nepal, with around half of all cases affecting the country's most productive age group, according to the National Tuberculosis Center (NTC). The World Health Organization (WHO) estimates Nepal sees 67,000 new TB cases annually, meaning roughly 33,500 patients fall within the 15–49 age bracket.
Dr. Bhuwan Paudel, Director of the NTC, revealed that in fiscal year 2024/25, 39,151 new drug-sensitive TB patients received treatment, but only 58% were officially identified. This leaves over 42% of patients—more than 27,000 people—still outside the treatment system. Nepal currently records 227 TB cases per 100,000 people, with around 16,000 deaths each year.
Highlighting the country's unique trend, Dr. Naveen Prakash Shah, a chest disease specialist, noted that while TB in other nations is more common among the elderly and children under 14, Nepal faces high infection rates in the working-age population, raising the risk of spreading the disease to other groups.
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Dr. Paudel also pointed to returnee migrant workers from Qatar, Kuwait, and Dubai as a growing segment of TB patients. "When the productive age group is affected, the impact is felt across families and communities," he said.
The NTC reported that Madhesh Province accounts for 25% of TB cases nationwide, followed by Bagmati (23%) and Lumbini (20%). The high prevalence in Madhesh is linked to low literacy, poor socio-economic conditions, and social stigma, which discourages patients from seeking treatment. Communal living practices further accelerate the spread of the disease, Dr. Paudel explained.
Treatment gaps and challenges
Despite government programs, 42% of TB patients remain outside treatment. Among the identified patients, 39% are women, 61% men, and 5.6% children under 15. Of those receiving care, 72% have pulmonary TB and 28% have TB in other organs.
Drug-resistant TB poses a growing challenge. Of around 2,400 drug-resistant patients, only 625 are under treatment, with a 74% recovery rate and 26% mortality. Poor adherence to medication increases the risk of transmission, making this group a key driver of TB in the community.
Nepal is ranked among the top 30 countries with high drug-resistant TB rates. While the government aims to eliminate TB by 2050, resource shortages, social stigma, and insufficient technical and healthcare personnel remain major hurdles.
Currently, Nepal has 142 centers providing PCR testing, 15 microscopy TB centers, 10 AI-assisted X-ray machines across seven provinces, and 149 municipalities included in the "TB-Free Nepal" campaign.
