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TUBERCULOSIS HIV

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TUBERCULOSIS HIV

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    1. TUBERCULOSIS & HIV Dares CHUSRI, B.N., M.P.H. Ph.D. Candidate, CPH, Chulalongkorn University Research Fellow TB/HIV Research Project

    2. Estimated number of adults and children infected with both HIV and TB at end 1999

    3. TB and HIV in South-East Asia Region

    5. Current State of the Thai Epidemic For the year 2001 1,009,000 have been infected since start 344,000 have died of AIDS 665,000 currently living with HIV or AIDS 26,000 new infections will occur this year 53,000 will develop serious illness 55,000 will die HIV remains a serious national concern Potential for epidemic relapse is high

    7. Why TB is serious? The TB bacillus infects 1/3 of the world’s and Thai’s population. Everyday, more than 1,500 people die of TB in SEAR. Within SEAR, more than 955 of TB case are found in India, Indonesia, BANGLADESH, Thailand and Myanmar. A parallel epidemic of TB is following the AIDS pandemic.

    8. The impact of TB/HIV. Major public health problem. -Extra burden and pressure on Hospital services. -Increase morbidity & mortality. -Premature death & ill health. -Increase medical expense. A serious impact on socioeconomic development. -The most productive age group. Impact on TB control. -MDR-TB have severe adverse reactions.

    9. The need to work together TB and HIV are both disease of poverty They affect also the young AIDS and TB are often indistinguishable Treatment of both is long, complicated and carries risk of resistance Both are preventable Both require extensive health infrastructure to support prevention, care, and support.

    10. Stop TB -Limit TB transmission, save the life of PLWH. Stop TB - Make TB free environment Stop HIV - Reduce the pool of TB population at risk Stop HIV = Stop TB DOTS, TB cured for all. DOTS cured HIV/TB.

    11. Strategies of HIV-TB Early Detection of TB and Screening Preventive Treatment (package of HIV care) Increase accessibility to information and TB services Readiness of health care program Special service detoxification program DOTS Coverage and Care Drugs assistant program Counseling and social services Community network of care and empowerment Policy support and local response

    12. Areas for Collaboration Development of National Guidelines Training Prevention Education Voluntary Counseling Testing HIV coordinator + HIV/TB coord. Home and Community Based Care Research and Study National Conference.

    13. Scopes of Accessibility Medical services: - VCT & Screening - OI prophylaxis and treatment - ARV therapy for appropriate patients - PMCT - Specific laboratory access (CD4,VL) Psychological support Socioeconomic service

    15. Prevention education focus on adolescent and hard to reach group Decrease Stigma & discrimination. Patient’s Rights Partner’s rights

    16. TB/HIV Program: Issues to consider Coordination is crucial: -Funding, human resources and infrastructure -Health education -Clinical management -Surveillance -Policy on chemoprophylaxis, BCG, HIV testing and counseling of TB patients... -Consider impact of AIDS treatment drugs (Hight Active AntiRetroviral Treatment)

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