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Group 2 Scale up : Intensified TB Case Finding (ICF) and Isoniazid Prophylaxis (IPT)

Group 2 Scale up : Intensified TB Case Finding (ICF) and Isoniazid Prophylaxis (IPT). Rapporteur: Dr. Massimo Ghidinelli Facilitator: Dr.Elvira Teodora Wi Member Countries: Thailand, Mongolia,Indonesia,East Timor,Cambodia, Vietnam,Fiji,Myanmar,Philippines,Laos. Achievements.

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Group 2 Scale up : Intensified TB Case Finding (ICF) and Isoniazid Prophylaxis (IPT)

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  1. Group 2Scale up : Intensified TB Case Finding (ICF) and Isoniazid Prophylaxis (IPT) Rapporteur: Dr. Massimo Ghidinelli Facilitator: Dr.Elvira Teodora Wi Member Countries: Thailand, Mongolia,Indonesia,East Timor,Cambodia, Vietnam,Fiji,Myanmar,Philippines,Laos

  2. Achievements • Majority of countries initiated Intensified Case Finding (ICF) • Thailand – achieved about 90% coverage • Majority of countries with policy, TB-HIV framework (7/10) • Some countries with infrastructure to conduct ICF including TB cultures

  3. ICF status

  4. Constraints • IPT - low implementation • No policy and clear guidelines • High prevalence of TB – difficult • Issues of development of resistance • Needs more substantial evidence for effectiveness • ICF – implementation mechanisms , no local level implementation • Difficulties of TB diagnosis in HIV positive patients

  5. Constraints • Collaboration between TB and HIV • Varied epidemiology – TB/HIV may not be overlapping • Level of implementation – TB well established program compared to growing HIV program • Different focus – TB (peripheral) and HIV (hospital based) • Stigma • Confidentiality – counseling and testing • Fast turn over of health care providers • Logistic - continuous support , who takes the lead in providing financial support • Articulated operationalisation of partnership between TB and HIV - limited

  6. Recommendations • Structural interventions • IPT – operational research – evidence to support policy (IPT effectiveness TB incidence, validation of new TB screening algorithms) and implementation of IPT • IPT - Advocacy /Communication– highly technical • Strengthen Monitoring & Evaluation • Enhance PITC

  7. Recommendations • Implementation review of services and strengthen referral mechanisms • Sensitization of PLHIV on benefits of IPT

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