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MDR-TB and TB Update: Rayong Province

MDR-TB and TB Update: Rayong Province. CAP-TB Strategic Planning Meeting August 1, 2013 Bangkok, Thailand. Chittima Thibbadee , M.D. Presentation Outline. Latest MDR-TB and TB prevalence At-risk populations Current effort Prevention Care and treatment. Presentation Outline.

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MDR-TB and TB Update: Rayong Province

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  1. MDR-TB and TB Update: Rayong Province CAP-TB Strategic Planning Meeting August 1, 2013 Bangkok, Thailand ChittimaThibbadee, M.D.

  2. Presentation Outline • Latest MDR-TB and TB prevalence • At-risk populations • Current effort • Prevention • Care and treatment

  3. Presentation Outline • Available resources/fundings • Available resources e.g. equipment, human resources, number of health facilities with the diagnosis and treatment capacity, etc. • Funding sources, period and focuses • Challenges and Gaps

  4. Pattaya Rayong

  5. Latest MDR-TB and TB Prevalence

  6. TB Prevalence Rate in Rayong Province Between 2008 - 30 June 2013* Year *2013 data is between 1 October 2012 – 30 June 2013

  7. TB incidence (per 100,000) by WHO region, and in Thailand, 2011 TB incidence in Thailand is 2.5 – 4 times higher than Europe & America regions source: WHO, Global Tuberculosis Report 2012

  8. Number of case between 2008-June 2013 645 case 683 case651 case690 case640case 606 case ที่มา : TB 07

  9. MDR-TB Prevalence Rate in Rayong Province Between 2008 - 30 June 2013 พ.ศ. *2013 data is between 1 October 2012 – 30 June 2013

  10. Number of MDR-TB Patients by District

  11. At-risk Populations

  12. Current Effort

  13. Prevention • Early (MDR-TB) case detection, contact investigation • Quality DOT in drug-sensitive TB (DS TB) • Proper management of MDR-TB • Increase public awareness • World TB Day campaign

  14. Care and Treatment • TB clinics staffed with trained health personnel • Active /intensified case finding in different at-risk population groups • Sputum smear tests/culture to diagnose pulmonary TB by the National TB Program • Quality DOT

  15. Care and Treatment (cont) • Uninterrupted supply of quality TB drugs • Infection control in hospital/household levels • Integrated HIV/AIDS and TB program • Patient’s registration and reporting completeness • MDR-TB patient register implemented

  16. Available Resources

  17. Health Facilities and Diagnosis Capacity • 65 culture and identification laboratories (Solid media culture is performed at RayongHospital) • 35 DST laboratories (DST for FLDs/SLDs is also available at Siriraj Medical School/BTB) • 24 Molecular Assay laboratories (14 GeneXpert machines in Thailand, one at Rayong hospital with support from USAID|Asia through CAP-TB Project)

  18. Public and Private Health Facilities in Rayong Province

  19. Human Resources Health personnel who care for MDR-TB patients at Rayong Hospital • 2 Medical physicians (pulmonologist) • 1 Paediatrician • 1 Pharmacist • 1 Register Nurse (& counselor)

  20. Human Resources(cont) Health personnel who care for MDR-TB patients at Rayong Hospital • 4 Medical Technologist (lab staff) • 1 Counselor • Health worker (home visit) - Full time 2 - Part time 3

  21. Current Funding Sources • National Health Security Office (NHSO) – ongoing Objectives: 1. Active case findings/screening amongst at-risk populations and close contacts of TB/MDR-TB patients 2. Directly-observed therapy (DOT) by trained personnel for TB/MDR-TB patients

  22. Current Funding Sources • Global Fund – to be ended in September 2014 Objectives: 1. Support the implementation of DOTS in all communities in three districts in Rayong Province • Facilitate TB/HIV activities • Empower community in TB prevention and control • Provide living support to patients

  23. Current Funding Sources • USAID | Asia through CAP-TB Project – to be ended in September 2016 Objectives: • Strengthen MDR-TB prevention and management among at-risk population groups • Support active case findings/screening among HIV infected persons, diabetics, elderly persons and migrant population in four communities in three districts in Rayong Province. • Provide package of service to patients to support treatment adherence.

  24. Current Funding Sources  Local administration organization – ongoing Objectives: • To support project implementation according to the need and priority of the areas

  25. Current Funding Sources  Local administration organization – ongoing Objectives: • To support project implementation according to the need and priority of the areas

  26. Challenges and Gaps

  27. Prevention

  28. Diagnosis

  29. Care and Treatment

  30. Thank you For your attention

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