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Country Profiles - Timor-Leste
The estimated population for Timor-Leste is 1 155 187.
The NTP is functioning in all 13 districts and 65 sub-districts of the
country, with the district TB coordinators (DTCs) working within the district
health management teams in all districts and with the 65 community health
centres (CHCs) at sub-district level. The estimated prevalence of all forms
of TB and incidence of smear-positive TB is 378 and 145 per 100 000
population respectively. The revised estimates for TB in the country are
based on recent prevalence studies carried out in East Nusa Tenggara province
and on a house-to-house active survey of pulmonary TB carried out in the sub-district of Bazartette in 2006-2007. A case
detection rate* of 61% was achieved in 2007, while the treatment success rate
for the patients registered for the cohort 2006 was 79%.
It is estimated that MDR-TB rates are 1.6% among newly
diagnosed and 14.5% among previously treated TB cases. A Green Light
Committee approved MDR-TB case management project is in place. The National
TB Control Programme has established a treatment center in the NGO facility
of Klibur Domin in the district of Liquica. Two MDR-TB patients are currently
enrolled for management at this centre. GDF is providing the necessary
second-line, anti- TB drugs supported through UNITAID. The Institute of Medical
and Veterinary Sciences, Adelaide,
Australia, is
providing assistance for sputum culture and sensitivity testing for diagnosis
and follow up, and also provides technical assistance for TB laboratory
services.
HIV remains relatively uncommon in Timor-Leste. However,
the country reported 56 cases of HIV infection among whom two were confirmed
to have active TB. Surveillance is conducted through routine notifications.
Initial collaboration between the National TB Control Programme and the
National AIDS Programme has been established.
The TB programme is supported by Global Fund Round 7 and
other bilateral partners. Presently, three of the 18 microscopy centres are
based in NGO facilities. Four NGO facilities are providing ambulatory care
and one is providing in-patient MDR-TB management. There are five other NGOs
which support the NTP in identification of TB suspects and referral to DOTS
facilities for diagnosis and treatment. Civil society participation is
expected to improve and expand with the infusion of Global Fund resources.
Major achievements
Global Fund Round 7 proposal approved;
NTP manual and reporting forms revised;
Country-specific TB estimates revised;
MoU signed with supranational laboratory in Australia for culture and DST;
MDR-TB case management launched in July 2008;
TB/HIV collaboration established at national level;
Expansion of TB control services to three prisons;
Public-private mix (PPM) guidelines drafted;
Drugs management training conducted;
Laboratory technicians’ training completed in June 2008;
Expatriate doctors working in Community Health Centres (CHCs), and hospitals
trained by NTP.
Major challenges
and constraints
Inadequate capacity at national, district and sub-national levels;
Inadequate access to NTP services in many areas of the country;
Low community awareness about TB and NTP services;
High default rates particularly in Dili district;
Low case detection rate and inadequate implementation of DOT;
Over-diagnosis of TB in the national hospital, referral hospital and some
CHC, as not all doctors follow NTP guidelines; and
Weak drug and data management.
Planned activities
Revising the national laboratory manual;
Developing training modules for District TB Coordinators (DTCs) and
Regional Supervisors;
Training and refresher training of DTCs and Regional Supervisors;
Recruiting additional TB staff at national and CHC level;
Study tour for DTCs and regional supervisors to learn from best
practices elsewhere in the Region;
Involving NGOs to extend services to uncovered areas;
Increasing the involvement of the community; and
Improving Monitoring and Evaluation-
 • Six-monthly regional meetings and quarterly
meeting with DTCs;
• Resuming regular supervision to districts
and CHCs.
TB epidemiological
profile, Timor-Leste
TB Unit of the WHO Regional
Office for South-East Asia
* The new smear positive care
detection rate is 68% when calculated using the most recent national population
figure which is 1 043 632.
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