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Process and Products of TB/HIV Operational Research Chiang Rai, Thailand

Process and Products of TB/HIV Operational Research Chiang Rai, Thailand. Jintana Ngamvithayapong-Yanai, PhD. JSPS-Fellow, Research Institute of Tuberculosis, Japan TB/HIV Research Foundation, Chiang Rai, Thailand Ittipol Chaita, M.D. Director, Chiang San Hospital, Chiang Rai, Thailand.

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Process and Products of TB/HIV Operational Research Chiang Rai, Thailand

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  1. Process and Products of TB/HIV Operational Research Chiang Rai, Thailand Jintana Ngamvithayapong-Yanai, PhD. JSPS-Fellow, Research Institute of Tuberculosis, Japan TB/HIV Research Foundation, Chiang Rai, Thailand Ittipol Chaita, M.D. Director, Chiang San Hospital, Chiang Rai, Thailand Seventh International Congress on AIDS in Asia and the Pacific Kobe 2005, July 1-5, 2005

  2. Acknowledgement • Japanese Foundation for AIDS Prevention (JFAP) support the operational research activity • staff of Chiang San and Mae Chan Hospitals • People with HIV/AIDS volunteers in Chiang San and Mae Chan

  3. WHO Interim policy on collaborative TB/HIV Activities, 2004

  4. How to implement TB/HIV activities in Thailand where “district hospitals” are well established in every district?

  5. District (Community) Hospital in Thailand (10-90 beds --- for 30,000 – 100,000+ population)

  6. Operational Research (OR) Operations researchis concerned with the day-today operations of programs. It is intended to provide the information for improving service delivery activities and plan for the better future service. It seeks practical solutions to problem situations (Fisher et.al 1981) INT J TUBERC LUNG DIS 2005;2:145–150

  7. China Vietnam Myanmar Laos Chiang Rai Bangkok Cambodia • Pilot Area for TB/HIV Operational Research (OR) • Chiang Rai province • Chiang San district (about 56,000 population) • Mae Chan district (about 120,000 population)

  8. Process of OR for TB/HIV • Research team • -Operational researchers (PHA leaders, doctor, TB staff, HIV staff, lab, pharmacist, ICN) • -External researchers • Research fund and incentive • Evaluation and monitoring (meeting and presentation by analysis of medical records and registration)

  9. Integrating TB/HIV care in district hosp. HIV-positive is detected TB is detected TB education and Information about IPT • HIV Testing • HIV Education • TB education • TB screening HIV-negative HIV-positive Non-TB Active TB disease DOT for TB treatment and HIV care (cotrimoxazole and ARV) DOT for TB treatment and HIV education DOT for TB treatment and HIV care • IPT • HIV care -ARV

  10. The three-100% targets for TB/HIV activities in Chiang San Hospital 100% VCT among TB patients(100% of TB patients receive VCT) 100% Knowing TB(100% of People with HIV (PHA) to receive TB education) 100% TB Screening(100% of PHA to receive TB screening)

  11. 100%-Voluntary Counseling and Testing (VCT) for TB patients • One stop service - VCT - Drug counseling and dispensary

  12. TB education and TB screening for PHA • (hospital and community based approach) • Hospital -- by hospital staff • Community -- by PHA-Leaders incollaboration with the hospital and community council

  13. Method (community based) • PHA leaders provided TB knowledge through an interactive discussion using local language • Before and after TB education session, PHA performed the 15-minute test

  14. Teaching materials • TB knowledge Posters • TB patient’s chest x-ray films • A microscopic with slides showing TB germs • Pre and Post-test (11questions with 4 multiple-choices)

  15. Table 2 Mean scores of pre and post-test for each question

  16. Table 3: Result of TB screening among New-PHA at Chiang Saen Hospital

  17. Result of TB screening in the community by PHA leaders in 2004 134 PHA were screened for TB by a questionnaire 14 PHA were referred to Hospital 1 PHA was diagnosed with Pulmonary TB

  18. Targets and achievement

  19. Please help my PHA friends not to die with TB…. Ms.Petcharin...PHA volunteer in the closing of TB/HIV Symposium, International AIDS Conference, July 2004, Bangkok

  20. ‘Give a man a fish and you feed him for a day. Teach him to fish and you feed him for a lifetime.’ Chinese proverb. (quoted by Laserson et al., INT J TUBERC LUNG DIS 2005;2:145–150)

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