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2553

12 2553

6


  • 6 .



Estimated epidemiological burden of TB, 2008


Estimated TB incidence rates, 2008


Estimated HIV prevalence in new TB cases, 2008


HIV testing for TB patients, 2008


Number of cases of MDR-TB estimated, notified and expected to be treated, 27 high MDR-TB burden countries and WHO regions.


Notified cases of MDR-TB (2005-2008) and projected numbers of patients to be enrolled on treatment (2009-2010), The numbers under each bar show the number of countries

reporting data.


  • 11.1

  • 8.8

  • 1.3

  • 15%

  • ( MDR) 5


2008

  • Case notified new & relapse 5.7

  • Case detection rate among new smear positive 62%

  • Case detection rate for all TB cases 61%

  • Treatment success 86% in 2007

  • HIV testing among TB 22%

  • CPT and ART for TB/HIV 71%, 32%

  • ICF among PHA 4.1 % IPT 0.2%

  • MDR-TB treated 29%



2008





QualityDOTS

  • Case detection New SS+

  • treatment success

  • ( NM- , retreatment )


(TB case notification) 2546 - 2552

:2552 . (21 2553 )

:


(Case detection rate) 2546 - 2552

:2552 . ( 21 2553)

:


2546 - 2551

(Treatment outcome of New SS+ TB cases registered in Thailand ,2003 -2008

: 21 2553


2546 - 2551

(Unfavorable outcome of New SS+ TB patients registered in Thailand,2003 - 2008

: 21 2553


2546 - 2551

(Treatment outcome of New SS- TB cases registered in Thailand ,2003 -2008

: 21 2553


2546 - 2551

(Treatment outcome of RelapseTB cases registered in Thailand ,2003 -2008

: 21 2553


2546 - 2551

(Treatment outcome of TAF TB cases registered in Thailand ,2003 -2008

: 21 2553


2546 - 2551

(Treatment outcome of TAD TB cases registered in Thailand ,2003 -2008

: 21 2553


Quality DOTS

  • ( very strong commitment)

  • lab

  • Improve DOT ( non-family DOT)

  • FDC


TB/HIV

  • ART CPT


2549 -2552

Counseling

CD4-Testing

CD4<250

ARV

HIV-Testing

TB patients

HIV infection

CPT

: 21 2553

2552

2549

2550

2551


Intensified TB finding among newly detected PHAs in Thailand ,2006- 2009

%newly detected PHAs

2549

2550

2551

2552

(2006)

(2007)

(2008)

(2009)

: 21 2553


2549 -2552(1..51- 30..52)

: 21 2553


(ARV)

2549 -2552(1..51- 30..52)

: 21 2553


2549 - 2551

HIV STATUS

2549

2550

2551

: 21 2553


TB/HIV

  • national TB/HIV committee

  • IC

    • admission 2 weeks

    • IC . ( GF8 )

    • 31

      ( GF8 )

    • 6 ( TUC )

  • 3 IPT 8

    ( TUC )


MDR-TB

  • CAT 4

  • MDR-TB

  • 2

  • DST MDR-TB retreatment , on treatment , pre-treatment

  • GLC (Green Light Committee)


Second line 2552

396

74

68

43

39

37

33

36

25

14

15

20

14

:


TB in prison

  • mobile X-ray

  • (NCCM)


(TB case notification) 2546 2552-2552

3 cohort

2552

: 21 2553


2546 - 2551

: 21 2553


TB in migrants


---

(Case Finding Activities in Non-Thai )

: 25-26 2552


(Treatment Outcome of new m+ Case)

2549

2550

792

1,097

:

25 26 2552



HSS : Laboratory network

  • lab. 12 . (GF6)

  • lab. ( GF6 ) ;

  • culture DST guideline

  • Revise criteria for culture and DST workload


HRD

  • MDR-TB , MIFA

  • 3

  • RTC

  • national TB guideline


PPM


Hospitals in Thailand

Public health hospital ~829

(MOPH)

BMA hospital 9

Public hospital 66

(non MOPH)

Academia hospital 11

Private hospital 322

:

:


PPM - Evolution

1999

NTP started by BTB and some region, 72 private hospitals (2009)

2004

TUC project, 27 private hospitals

2006

GFATM round 1, 11 private hospitals (2009)

2008

GFATM round 6, 63 private hospitals (2010)


PPM

. 1-12 .

. . .. .

53

PPM

.


ACSM

  • . incentive 600 . + GF8

  • . (GF8)


  • KM

  • Multi-center study 2

    • MDR-TB

    • TB

  • CRCN


2552


Challenges

  • Sustain strong political commitment

  • Improve success rate among all sm+ cases for prevent MDR-TB

  • Improve proportion of ART for TB/HIV

  • Systematic implementation of IC & IPT

  • Standard management of MDR-TB and improve R&R system to achieve the targets

  • Collaboration between prison to health services

  • TB control in illegal migrant

  • Effective functional of regional reference lab.

  • Strengthen and sustain PPM ( project to program)

  • Policy-driven research


Conclusion

  • Q-DOTS ,TB/HIV

  • Success .... MDR ?

  • MDR-TB

  • non-Thai

  • Lab

  • PPM GF6

  • (. .)


2550-2552

6 .


2550 2552 (Trend in Case Detection Rate)

Target


2551-2552 (Trend in Sputum Conversion Rate)

Target

56


2551-2552 (Trend in Sputum Conversion Rate)

57


2549-2551(Trend in Treatment Success Rate)

Target

58


2549-2551(Trend in Treatment Success Rate)

59


HIV TB 2550 -2552(Trend in HIV Testing in TB cases)

Target

60


ARV TB/HIV 2550 - 2552(Trend in ARV receiving in TB/HIV)

Target

61


2550 - 2552

62


MDR - TB 2550 - 2552


: (TB08)


Target 85%

Target 60%

: (TB-HIV01)


: (TB08)


Target 85%

Target 60%

: (TB-HIV01)


Conclusion

  • Q-DOTS ,TB/HIV

  • MDR-TB

  • Lab (C/S)

  • (.)

  • (PPM)


Thank you for attention


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