1 / 23

National HIV sero-prevalence surveillance system among TB patients in Cambodia

National HIV sero-prevalence surveillance system among TB patients in Cambodia. Presented by Khun Kim Eam, MD, MPH National Center for TB Control, CENAT. Background of Cambodia. Population 13 millions 181,035 Km ². TB epidemiology.

zofia
Download Presentation

National HIV sero-prevalence surveillance system among TB patients in Cambodia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. National HIV sero-prevalence surveillance system among TB patients in Cambodia Presented by Khun Kim Eam, MD, MPH National Center for TB Control, CENAT

  2. Background of Cambodia Population 13 millions 181,035 Km²

  3. TB epidemiology • Cambodia is one of the 22 high-burden countries of TB in the world • TB is one of the most priority communicable diseases in the Kingdom since 1980 • 64% of the total population has been infected with TB (WHO estimate, 2008) • TB incidence rate: 500/100,000 (all TB) 220/100, 000 (SM+TB) • Death rate: 92/100,000

  4. HIV epidemiology • First HIV case detected in 1991 and first AIDS case diagnosed in 1993 • Main route of HIV transmission: heterosexual • HIV/AIDS has spread rapidly in 1990’s • HIV prevalence among 15-49 age group peaked at 2.0% in 1998 and progressively declined up to 0.9% in 2006 • In 2008, about 50% of TB patients have been tested for HIV

  5. Rationale for TB HIV surveillance • To monitor the trend of HIV epidemic among TB patients, and assess the effectiveness of the TB/HIV control strategies, Cambodian NTP conducted National HIV sero-prevalence surveys among TB patients in 2003, 2005, 2007 and planned in 2009

  6. Objectives of HIV surveillance in TB settings • To determine HIV prevalence rate among confirmed TB patients (both smear positive pulmonary TB and other forms of TB) • To complement the National TB Prevalence survey results by assessing the impact of the HIV epidemic on the TB situation • To monitor the trend of the HIV epidemic by comparing the results with those in year 2003, 2005 and 2007 and assess the effectiveness of the TB/HIV control strategies

  7. Methods • Study design: Periodic anonymous unlinked cross-sectional surveys at all TB DOT services during a one month period (sample size: about 3,000) • Inclusion criteria: • Newly registered TB patients including the re-treatment cases • Any forms of TB (smear positive and negative pulmonary TB, and extra-pulmonary TB) regardless of diagnostic means • Any age and any nationality • Exclusion criteria: • TB patients who are transferred in from other operational district (OD) are excluded from this surveillance (to avoid duplicate) 7

  8. Methods • Blood sample collected for HIV testing from TB patients who consent to the survey • Samples tested at CENAT laboratory by 2 rapid tests (1st test: Determine HIV1/2, if positive, confirmed by the 2nd test :Uni Gold) • Patient’s demographic and TB information also collected • Data management and analysis: results of HIV testing and demographic and TB data are entered and analyzed using SPSS

  9. Year 2007 survey Results

  10. Year 2007 Result: Characteristics of the participants and HIV prevalence

  11. Result:Characteristics of the participants and HIV prevalence

  12. HIV prevalence trends from 2003 to 2007 by province

  13. HIV sero-prevalence trend among TB cases 14

  14. Overall Results • HIV prevalence among TB patients is decreasing (11.8% 2003, 9.9% 2005, 7.8% 2007) following the decreasing of HIV prevalence rate in Cambodia • HIV prevalence is significantly higher among reproductive age, children, non-Cambodian, EP TB or P+EP TB • HIV prevalence in Phnom Penh is still high but decreasing. • HIV prevalence in costal provinces and Thai border provinces is still high 15

  15. Strengths of Cambodia HIV sero-surveillance in TB patients • Useful (only 50% TB patients routinely tested for HIV) • Standardized protocol • Regular surveys over time allow for trend analysis • Good quality data • Results used for program planning and also for estimating male to female ratio of HIV prevalence among general adult population

  16. Challenges • Labor intensive • Funding (WHO/JICA in 2003, GFATM in 2005 and 2007): 80,000 USD per round • Ethical concern: HIV test results not given back to patients

  17. Perspectives for the future • Can we use routine program data for surveillance ? not yet in 2009 but we will start in 2010 when Cambodia will reach >70% HIV testing rate among TB patients

  18. Thank you for your attention

  19. HIV Prevalence Among Adult pop. 15-49 between 1995 and 2006 20

  20. Operational Procedure

  21. Sample Collection Delivery Pack

  22. Blood Collection Syringe system Vacutainer system

More Related