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The 6 poles Where are we now ? and The way forwards

The 6 poles Where are we now ? and The way forwards. ยุทธิชัย เกษตรเจริญ พ.บ. นายแพทย์ทรงคุณวุฒิ รก.ผอ.สำนักวัณโรค (30 มิถุนายน 2553 : โรงแรมมิราเคิล แกรนด์ คอนเวนชั่น ). Pole 1 : DOTS Sustain commitment? (e1) Dx base on (quality) bacteriology (e2)

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The 6 poles Where are we now ? and The way forwards

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  1. The 6 polesWhere are we now ? and The way forwards ยุทธิชัย เกษตรเจริญ พ.บ. นายแพทย์ทรงคุณวุฒิ รก.ผอ.สำนักวัณโรค (30 มิถุนายน2553 : โรงแรมมิราเคิล แกรนด์ คอนเวนชั่น)

  2. Pole 1 : DOTS • Sustain commitment? (e1) • Dx base on (quality) bacteriology (e2) • DOT : Think beyond to community dot (e3) • FDC (e3): Fixed 2, Fixed 4 in NTP • The VMI and regular drug supply (e4) • Electronic record and report (e5)

  3. Pole 2 : TB/HIV • Collaboration at all levels Structure function • ART provision in TBC or HIV clinic? • IPT in HIV clinic

  4. Pole 2 : TB/HIV • The “3Is” • ICF Improve Diagnosis of TB in HIV+ • IPT Feasibility / CEA • ICSurveillance of TB among HCWs • IC : The “3 principles”, Admission

  5. Pole 2 : TB/HIV • ART Death • CD4 level to initiate ART (CD4<350)

  6. Pole 2 • Revise definition of PTB SS Pos, PTB SS Neg, EP in HIV+/TB patients e.g PTB SS+ 1. One SS+ 2. Confirm HIV 3. Strong Clinical evidence of HIV infection

  7. PSS SS Neg • At least 2 SS NEG • CXR abnormal • Confirm HIV • Strong clinical evidence of HIV infection • Decision by clinical or • Ds Neg culture+

  8. Pole 2 : MDR • SA : research on MDR-TB • GLC and SLDs • Lab network : the NHSO • Criteria to culture / DST “ Re on Pre” • Record / Report : base on guide line electronic

  9. Pole 2 : MDR Dot and MDR management “ community dot “

  10. Pole 2 : Childhood TB • SA : research on childhood TB • GLC : pediatric formulation

  11. Pole 2 : TB in prison • NCCM : the new jigsaw • Screening of TB in prison : before and after • Collaboration of prison and hospital

  12. Pole 2 : TB in migrant • Information, data FLDs • Who pay?SLDs Culture/DST

  13. Pole 3 : HSS • Electronic record and report • TB data management unit • Lab capacity building • HR data management TB as an entry point to strengthen existing health system ??

  14. Pole 4 : PPM • Private hospitals engagement : record / report • University hospitals engagement : record / report • Other (Military, Police – etc) • PPM annual report • More case report to NTP

  15. Pole 5 : ACSM • Models of Local health authority in TB control • Policy • Budget • HR

  16. Pole 5 : ACSM • Social mobilization in TB Medias

  17. Pole 6 : Research • Site of clinical trial in new dregs, • Site of clinical trial in new vaccine • Hain test (LPA : Line – Probe Assay)

  18. Thank you

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